Comparable Results With Porous Metal Augments in Combination With Either Cemented or Uncemented Cups in Revision Hip Arthroplasty: An Analysis of One Hundred Forty-Seven Revisions at a Mean of Five Years

Abstract

Background: Porous metal augments have been used successfully for management of large acetabular defects during revision hip arthroplasty. The purpose of this study was to retrospectively review and compare the clinical and radiographic outcomes of porous metal augments in cemented and uncemented acetabular revisions, all performed at the same institution.

Methods: Using our institutional clinical databases, the clinical and radiological outcomes of 104 cemented and 43 uncemented acetabular revisions with metal augments, performed between 2006 and 2015, were studied and compared. Acetabular augments were used when preoperative and intraoperative findings indicated the presence of large acetabular defects that can hinder the stability of the revision implants.

Results: At a mean follow-up of 60.1 months (range 12.7-112.1), a total of 5 cups (3.4%), being 3 cemented (2.8%) and 2 uncemented (4.6%), had shown signs of aseptic loosening with cup and augment migration and 4 of these have been re-revised (2.7%). At final follow-up, the European Quality of Life-5 Dimensions for generic health, and the Hip disability and Osteoarthritis Outcome Score (HOOS) parameters had improved substantially without any significant difference between fixation techniques.

Conclusion: Porous metal augments show comparable excellent radiographic and clinical mid-term outcomes when combined with cemented or uncemented cups in revision hip arthroplasty.

Keywords: acetabular defects; bone cement; cup revision; impaction grafting; porous metal augments; revision hip surgery.