Tantalum in type IV and V Paprosky periprosthetic acetabular fractures surgery in Paprosky type IV and V periprosthetic acetabular fractures surgery

• Published in: Musculoskeletal surgery Vol. 102; no. 1; pp. 87 - 92
• Main Authors: Falzarano, G., Piscopo, A., Rollo, G., Medici, A., Grubor, P., Bisaccia, M., Pipola, V., Cioffi, R., Nobile, F., Meccariello, L.
• Format: Journal Article
• Language: English
• Published: Milan Springer Milan 01.04.2018; Springer; Springer Nature B.V
• Subjects: Analysis; Biological products; Fractures; Health aspects; Hip joint; Joint surgery; Medicine; Medicine & Public Health; Original Article; Orthopedics; Surgery; Surgical Orthopedics; Tantalum; Paprosky acetabular classification; Bone loss; Hip revision surgery; Outcomes; Acetabular periprosthetic fractures
• ISSN: 2035-5106; 2035-5114
• DOI: 10.1007/s12306-017-0503-y

Purpose Periprosthetic acetabular fractures represent a growing and serious complication of total hip arthroplasty (THA). The purpose of the study is to report our experience in the use of tantalum for the treatment of Paprosky type IV and V periprosthetic acetabular fractures. Method We analyzed 24 patients with type IV and V periprosthetic acetabular fractures. Patients were treated with a revision surgery using tantalum components, in some cases in association with posterior plating. Outcomes were evaluated using VAS, Harris hip score and considering the average time of integration of the acetabulum and the number of complications. The endpoint evaluation was established at 24 months. Result Results show that the average time of integration of the neoacetabulum in tantalum was 12.3 months (range 6–18 months). The average VAS pain is 8.7/10 cm at time 0 and gradually returns to basic pre-injury values in the following months. The average value of HHS at time 0 is 13.5 points. This value tends to increase progressively until reaching a mean score of 89.3 points at 24 months, higher than the average pre-trauma value of 84.3 points. Conclusion Periprosthetic fractures of the acetabulum with bone loss are a rare but potentially disastrous complication of total hip prostheses. Their management and therapeutic choice will test the ability of the orthopedic surgeon. It is important to determine the type of fracture and characteristics in order to pursue an adequate therapeutic strategy. The modern biomaterials, such as porous tantalum, offer a greater potential in replacing bone loss, promoting bone regrowth and obtaining a stable implant.