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. 2020 Jan-Feb;11(1):56-61.
doi: 10.1016/j.jcot.2018.08.009. Epub 2018 Aug 11.

Cementless jumbo cups for revision of failed Furlong prosthesis. A case series

Ahmed Salem Eid  1 , Ahmed Kotb  1 , Waleed Elshabrawy  1
Affiliations

Cementless jumbo cups for revision of failed Furlong prosthesis. A case series

Ahmed Salem Eid et al. J Clin Orthop Trauma. 2020 Jan-Feb.

Erratum in

  • Erratum regarding previously published articles.
    [No authors listed] [No authors listed] J Clin Orthop Trauma. 2020 Nov-Dec;11(6):1169-1171. doi: 10.1016/j.jcot.2020.09.032. Epub 2020 Sep 26. J Clin Orthop Trauma. 2020. PMID: 33013141 Free PMC article.
  • Erratum regarding previously published articles.
    [No authors listed] [No authors listed] J Clin Orthop Trauma. 2020 Nov-Dec;11(6):1172-1174. doi: 10.1016/j.jcot.2020.10.044. Epub 2020 Oct 23. J Clin Orthop Trauma. 2020. PMID: 33192025 Free PMC article.

Abstract

Background: Revision of failed total hip arthroplasty (THA) presents great challenge to any orthopaedic surgeon especially in the presence of acetabular defects where the main goal is to achieve durable fixation of prosthetic components to bone which is the key to successful revision surgery.

Methods: Seventeen patients (17 hips) with mean age of 52 (40-61) years had revision surgery for aseptic failure of Furlong hydroxyapatite-ceramic-coated (HAC) prosthesis using cementless jumbo cups. Patients were reviewed clinically and radiographically with mean follow-up of 3.5 years (2-6). No patient was lost to follow up.

Results: All revised acetabular components showed polyethylene wear, severe metallosis, with acetabular defects IIB (4/17), and IIIA (13/17) according to Paprosky classification. The femoral component was well fixed in all cases but one patient had stem revision for femoral fracture mal-union. There was one early post-operative infection; there was no postoperative dislocation, sciatic nerve injury, periprosthetic fracture or deep venous thrombosis. At last follow-up, no progressive radiolucencies or acetabular migration was identified. The mean Harris hip score improved from 42 (24-59) pre-operatively to 85 (72-92).

Conclusion: Good clinical results and radiographic stability were obtained at short term follow up after acetabular revision using cementless jumbo cups, which justify its use in revision surgery even in the face of major acetabular defects. Furlong HAC femoral component gives excellent long-term survival in young and active patients with a survival rate of 94% at 18.6 years.

Keywords: Acetabular revision; Arthroplasty; Furlong; Jumbo cup.

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Figures

Fig. 1
Fig. 1
A Severe metallosis and B. severe polyethylene wear were common features encountered in all cases.
Fig. 2
Fig. 2
A. Pre-operative radiographs of a 43-years-old female patient with failed Furlong acetabular component with type IIIA acetabular defect; B. Postoperative radiographs after 3 months C. after 3 years; D. last follow-up after 6 years with no signs of loosening or cup migration, with HHS improved to 92.
Fig. 3
Fig. 3
A. Pre-operative anteroposterior (AP) radiograph of hip in 47-year-old man with Ankylosing Spondylitis had failed Furlong cup and mal-union fracture shaft femur; B. immediate post-operative radiographs; C. last follow-up after 2.5 years with stable cup, no signs of loosening, and fully united femur at the corrective osteotomy site, with HHS improved from 29 to 76.
See this image and copyright information in PMC

References

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