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Observational Study
. 2019 Jul;98(27):e16090.
doi: 10.1097/MD.0000000000016090.

Acetabular reconstruction for primary and revision total hip arthroplasty using Kerboull-type acetabular reinforcement devices-case-control study with factors related to poor outcomes of surgery

Yoshinobu Masumoto  1 , Shigeo Fukunishi, Tomokazu Fukui, Yu Takeda, Shoji Nishio, Yuki Fujihara, Shohei Okahisa, Taishi Okada, Shinichi Yoshiya
Affiliations
Observational Study

Acetabular reconstruction for primary and revision total hip arthroplasty using Kerboull-type acetabular reinforcement devices-case-control study with factors related to poor outcomes of surgery

Yoshinobu Masumoto et al. Medicine (Baltimore). 2019 Jul.

Abstract

Kerboull-type acetabular support rings (KT) and allogenic bone graft were used for severe periacetabular bone loss with primary and revision total hip arthroplasty (THA). The purpose of this case-control study is to evaluate the risk factors related to poor outcomes of surgery.Sixty patients underwent primary THA and revision THA using allogenic bone graft with KT for large acetabular deficiency. These patients were retrospectively evaluated postoperatively and followed-up by radiograph. The minimum follow-up period was 4 years and averaged 7 years. A radiological failure was defined by the following criteria:Expected risk factors were defined as female, age >75 years, body mass index (BMI) >25%, medical history of hypertension, renal failure, liver steatosis, diabetes, hyperlipidemia, cardiac infarction, smoking, American Academy of Orthopedic Surgery (AAOS) classification III or IV, bleeding>500 mL, time of surgery >3hours, high hip center-type KT, inclination of KT >45 degrees, screw angle >25 degrees, morselized bone graft, Kawanabe's classification stage 3 or 4 and revision surgery. Nineteen hips (31.6%) revealed radiological failure according to our criteria, and revision THA was performed in 2 hips (3.3%). In the statistical analysis, morselized bone graft and high hip center-type KT were identified as factors of poor outcomes of surgery.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Schematic drawing of the 2 types of KT and bone graft. A. OC-type KT. OC-type KT could place the cup in origizal acetabulum. B. HH-type KT. The HH-type KT could decrease the volume of bone graft and enables the cup to be placed in the high hip center. HH = high hip center-type, KT = Kerbull-type acetabular support rings, OC = original cup center-type.
Figure 2
Figure 2
X-ray radiograph of the hip with 57-year-old man. A. at initial visit. B. after first revision surgery with HH-type KT and a structural bone graft. C. ten years after revision surgery. D. after re-revision surgery with OC-type KT and a structural bone graft. HH = high hip center-type, KT = Kerbull-type acetabular support rings, OC = original cup center-type.
Figure 3
Figure 3
X-ray radiograph of the hip with 77-year-old woman. A. at initial visit. B. after first revision surgery with HH-type KT and a morselized bone graft. C. nine years after revision surgery. D. after re-revision surgery with OC-type KT and a structural bone graft. HH = high hip center-type, KT = Kerbull-type acetabular support rings, OC = original cup center-type.
See this image and copyright information in PMC

References

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