Modular revision strategy with bispherical augments in severe acetabular deficiency reconstruction

• Published in: International orthopaedics Vol. 46; no. 2; pp. 215 - 222
• Main Authors: Li, Guo-yuan, Zhang, Xiao-qi, Chen, Min, Luo, Zheng-liang, Ji, Xiao-feng, Shang, Xi-fu
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.02.2022
• Subjects: Acetabulum - diagnostic imaging; Acetabulum - surgery; Arthroplasty, Replacement, Hip - adverse effects; Arthroplasty, Replacement, Hip - methods; Follow-Up Studies; Hip Prosthesis - adverse effects; Humans; Medicine; Medicine & Public Health; Original Paper; Orthopedics; Prosthesis Failure; Reoperation; Retrospective Studies; Treatment Outcome; Reconstruction; Augments; Acetabular defect; Revision total hip arthroplasty
• ISSN: 0341-2695; 1432-5195
• DOI: 10.1007/s00264-021-05195-y

Purpose Reconstruction of severe acetabular deficiency is extremely challenging in total hip arthroplasty (THA) revisions. Novel bispherical augments were designed to fill acetabular bone loss and facilitate restoration of hip center of rotation (HCOR). Current study aims to compare the outcomes of bispherical augments and tantalum augments. Methods Between July 2017 and December 2018, bispherical augments (BA group) were implanted in 25 patients (25 hips) and 22 patients (22 hips) underwent porous tantalum augments (TA group) reconstruction in revision THA. Clinical and radiographic results were evaluated for 25 hips in BA group and 20 hips in TA group at the final follow-up. The mean duration of follow-up was 2.9 years (range, 2.2 ~ 3.7) in BA group and 2.9 years (range, 2.3 ~ 3.8) in TA group. Results Harris hip scores, HCOR, and leg length discrepancy (LLD) correction did not differ between the treatment groups. The bispherical augments were located more closer to the medial-superior part (zone II) of acetabular shell while the majority of tantalum augments were located at the lateral-superior part (zone I) ( P  = 0.010). More screws were used in the BA group for augment fixation (mean 2.1 vs. 1.3) ( P  = 0.000). There was no evidence of loosening or migration in all hips. Only one dislocation occurred in BA group and treated with closed reduction, no recurrence of instability up to the final follow-up. Conclusion The clinical and radiological outcomes of bispherical augments were comparable with tantalum augments; this technique was a reliable alternative method in severe acetabular deficiency reconstruction.