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. 2008 Apr;32(2):189-93.
doi: 10.1007/s00264-006-0307-4. Epub 2007 Jan 13.

Acetabular revisions using a cementless oblong cup: five to ten year results

R Civinini  1 , A Capone, C Carulli, M Villano, M I Gusso
Affiliations

Acetabular revisions using a cementless oblong cup: five to ten year results

R Civinini et al. Int Orthop. 2008 Apr.

Abstract
in English, French

The purpose of this paper was to evaluate the results of acetabular revisions with the use of an oblong revision cup that is designed with its longitudinal diameter elongated relative to its transverse diameter. Between 1996 and 2001, 62 hips in 60 patients underwent an acetabular revision with the insertion of a LOR acetabular component. Seven hips were lost to follow-up or the patients died; the remaining 55 hips (53 patients) remained in follow-up for an average of 7.2 years (range: 5.0-10.1 years). One socket was revised for aseptic loosening, and another was operated on for a late polyethylene liner dissociation. The average Harris hip score (HHS) improved from 34 to 79. Results were rated as excellent in 16 hips, good in 28, fair in six and poor in three. Radiographic analysis demonstrated an improvement in the average vertical displacement of the hip centre: 49 hips had a well-fixed, bone-ingrown cup and four had a stable fibrous union. For large superolateral acetabular bone deficiencies, this implant facilitated a complex reconstruction without the need for bulk structural acetabular bone grafts, provided good clinical results and showed satisfactory stability at the midterm follow-up.

Le but de cette étude est d’évaluer les résultats des révisions acétabulaires par l’utilisation d’une cupule oblongue. 62 hanches chez 60 patients ont bénéficié de cette révision acétabulaire avec cet insert (LOR). Ces révisions ont été réalisées de 1996 à 2001. 7 hanches ont été perdues de vue ou les patients décédés, 55 hanches (53 patients) ont été suivies en moyenne pendant 7,2 ans (de 5 à 10,1 ans). Une cupule a été révisée pour descellement aseptique et une autre a été reprise pour un débricolage de l’insert en polyéthylène. Le score HHS moyen a été amélioré passant de 34 à 79. Les résultats ont été cotés comme excellents dans 16 hanches, bons dans 28 hanches, moyens dans 6 hanches et mauvais dans 3 hanches. L’analyse radiographique a montré une amélioration du centrage de la hanche, 49 implants sont considérés comme bien en place et bien fixés, 4 hanches ont une fixation fibreuse mais stable. Cet implant facilite les reconstructions difficiles lorsqu’il existe une perte de substance supérieure et latérale du cotyle sans qu’il soit nécessaire de greffer les patients par une allogreffe. Il permet d’avoir de bons résultats et montre une stabilité tout à fait satisfaisante à moyen terme.

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Figures

Fig. 1
Fig. 1
a Preoperative AP radiograph of a 68-years-old female with a large and oblong acetabular defect 5 years after a cementless primary total hip arthroplasty. b AP radiograph made 7 years after surgery
See this image and copyright information in PMC

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