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. 2023 May;47(5):1203-1212.
doi: 10.1007/s00264-023-05723-y. Epub 2023 Feb 22.

Medial wall reconstruction using metal disc augments in revision total hip arthroplasty

Wang Deng  1 , Tiemure Wu  1 , Zhaolun Wang  1 , Hongyi Shao  1 , Dejin Yang  1 , Yixin Zhou  2
Affiliations

Medial wall reconstruction using metal disc augments in revision total hip arthroplasty

Wang Deng et al. Int Orthop. 2023 May.

Abstract

Purpose: Medial acetabular bone defects are frequently encountered in revision total hip arthroplasty (THA), but few studies have focused on their reconstruction. This study aimed to report the radiographic and clinical results after medial acetabular wall reconstruction using metal disc augments in revision THA.

Methods: Forty consecutive revision THA cases using metal disc augments for medial acetabular wall reconstruction were identified. Post-operative cup orientation, the centre of rotation (COR), stability of acetabular components and peri-augments osseointegration were measured. The pre-operative and post-operative Harris Hip Score (HHS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) were compared.

Results: The mean post-operative inclination and anteversion were 41.88 ± 6.70° and 16.73 ± 5.35°, respectively. The median vertical and lateral distance between the reconstructed CORs and the anatomic CORs were -3.45 mm (interquartile range [IQR]: -11.30 mm, -0.02 mm) and 3.18 mm (IQR: -0.03 mm, 6.99 mm). Thirty-eight cases completed the minimum two year clinical follow-up, whereas 31 had a minimum two year radiographic follow-up. Acetabular components were radiographically stable with bone ingrowth in 30 cases (30/31, 96.8%) while one case was classified as radiographic failure. Osseointegration around disc augments was observed in 25 of 31 cases (80.6%). The median HHS improved from 33.50 (IQR: 27.50-40.25) pre-operatively to 90.00 (IQR: 86.50-96.25) (p < 0.001), whereas the median WOMAC significantly improved from 38.02 (IQR: 29.17-46.09) to 85.94 (IQR: 79.43-93.75) (p < 0.001).

Conclusion: In revision THA with severe medial acetabular bone defect, disc augments could provide favorable cup position and stability, peri-augments osseointegration, with satisfactory clinical scores.

Keywords: Bone defect; Disc augment; Medial acetabular wall; Revision total hip arthroplasty.

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