Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 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

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.

PubMed Disclaimer

References

    1. Walde TA, Mohan V, Leung S, Engh CA Sr (2005) Sensitivity and specificity of plain radiographs for detection of medial-wall perforation secondary to osteolysis. J Arthroplasty 20:20–24 - DOI - PubMed
    1. Hettich G, Schierjott RA, Ramm H, Graichen H, Jansson V, Rudert M, Traina F, Grupp TM (2019) Method for quantitative assessment of acetabular bone defects. J Orthop Res 37:181–189 - DOI - PubMed
    1. Dorr LD, Wan Z (1995) Ten years of experience with porous acetabular components for revision surgery. Clin Orthop Relat Res 319:191–200
    1. Dorr LD, Tawakkol S, Moorthy M, Long W, Wan Z (1999) Medial protrusio technique for placement of a porous-coated, hemispherical acetabular component without cement in a total hip arthroplasty in patients who have acetabular dysplasia. J Bone Joint Surg Am 81:83–92 - DOI - PubMed
    1. Blumenfeld TJ, Bargar WL (2012) Surgical technique: a cup-in-cup technique to restore offset in severe protrusio acetabular defects. Clin Orthop Relat Res 470:435–441 - DOI - PubMed

Publication types

LinkOut - more resources