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. 2016 Apr 20;129(8):903-8.
doi: 10.4103/0366-6999.179793.

Total Hip Arthroplasty Using Modular Trabecular Metal Acetabular Components for Failed Treatment of Acetabular Fractures: A Mid-term Follow-up Study

Affiliations

Total Hip Arthroplasty Using Modular Trabecular Metal Acetabular Components for Failed Treatment of Acetabular Fractures: A Mid-term Follow-up Study

De-Yong Huang et al. Chin Med J (Engl). .

Abstract

Background: Porous-coated cups have been widely used in acetabular reconstruction after failed treatment of acetabular fractures, and good results have been reported with the use of these cups; however, the durability and functionality of modular trabecular metal (TM) acetabular components in acetabular reconstruction after failed treatment of acetabular fractures remain unclear. This study aimed to examine the radiographic and clinical outcomes associated with the use of modular TM acetabular components for failed treatment of acetabular fractures to assess the durability and functionality of these components in acetabular reconstruction after failed treatment of acetabular fractures.

Methods: A total of 41 patients (41 hips) underwent total hip arthroplasty (THA) using modular TM acetabular components for failed treatment of acetabular fractures at our hospital between January 2007 and December 2012. Among these patients, two were lost to follow-up. Therefore, 39 patients (39 hips) were finally included in this study. The Harris hip score before and after the surgery, satisfaction level of the patients, and radiographic results were assessed.

Results: The mean Harris hip score increased from 34 (range, 8-52) before surgery to 91 (range, 22-100) at the latest follow-up examination (P < 0.001). The results were excellent for 28 hips, good for six, fair for three, and poor for two. Among the 39 patients, 25 (64%) and 10 (26%) were very satisfied and somewhat satisfied, respectively. All cups were found to be fully incorporated, and no evidence of cup migration or periacetabular osteolysis was noted.

Conclusions: Despite the technically demanding nature of the procedure, THA using modular TM acetabular components showed good durability and functionality and may be an effective reconstruction option for failed treatment of acetabular fractures.

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Figures

Figure 1
Figure 1
Radiographs of a 40-year-old woman who underwent two-stage reconstruction owing to arthritis, avascular necrosis, and infection. (a) Radiograph showing acetabular and femoral head fractures after high-energy trauma. (b) Radiograph obtained one year after open reduction and internal fixation showing posttraumatic arthritis, avascular necrosis of the femoral head, and improper union of the acetabular fracture. (c) Radiograph obtained at the first-stage operation showing removal of all instruments because of infection and placement of an antibiotic spacer. (d) Radiograph obtained at the second-stage operation showing reconstruction with trabecular metal acetabular components and a porous-coated stem.

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