A single centre study of 41 cases on the use of porous tantalum metal implants in acetabular revision surgery.
Acetabulum
/ surgery
Adult
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip
/ adverse effects
Bone Transplantation
Follow-Up Studies
Hip Prosthesis
/ adverse effects
Humans
Middle Aged
Porosity
Prosthesis Failure
Prosthesis-Related Infections
/ surgery
Reoperation
/ instrumentation
Retrospective Studies
Risk Factors
Tantalum
Treatment Outcome
Acetabular revision
Megaprostheses
Periprosthetic infection
Revision arthroplasty
Two-stage revision
Journal
BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565
Informations de publication
Date de publication:
22 May 2019
22 May 2019
Historique:
received:
28
12
2018
accepted:
14
05
2019
entrez:
23
5
2019
pubmed:
23
5
2019
medline:
18
12
2019
Statut:
epublish
Résumé
This study aims at investigating cup survival of porous tantalum revision cups and identifies risk factors for failure. We retrospectively reviewed 41 patients treated between 2010 and 2012. Main indications were aseptic loosening in 83% and two-stage exchange after periprosthetic joint infection in 17% of cases. Mean follow-up period was 72 months. Femoral megaprostheses were used in 13% of cases. Most defects were classified as Paprosky 3b (29%). Function was assessed using the Harris Hip score. Aseptic cup survivorship was 80% at 104 months (95% Confidence Interval 67.4-92.4). Overall implant survival was 73%. Major bone loss defects (Paprosky types 2c to 3b) were associated with a significantly higher rate of failure than minor defects (P = 0.002). There were eight cases of aseptic loosening (19.5%) and two of infection (4.9%). Previous surgeries, indication for acetabular revision, patient-related risk factors and use of megaprostheses did not significantly influence implant survival. The Harris Hip Score improved from a median of 40 (Interquartile range 31-45) to 82 (interquartile range 65-88) postoperative (P < 0.0001). In summary, the use of porous tantalum metal implants in acetabular revision surgery achieves good to excellent short- term and mid-term functional results and an acceptable complication rate relative to the extent of defect and previous surgery. However, one should be aware of potential limitations of the implants in addressing large defects and discontinuity.
Sections du résumé
BACKGROUND
BACKGROUND
This study aims at investigating cup survival of porous tantalum revision cups and identifies risk factors for failure.
METHODS
METHODS
We retrospectively reviewed 41 patients treated between 2010 and 2012. Main indications were aseptic loosening in 83% and two-stage exchange after periprosthetic joint infection in 17% of cases. Mean follow-up period was 72 months. Femoral megaprostheses were used in 13% of cases. Most defects were classified as Paprosky 3b (29%). Function was assessed using the Harris Hip score.
RESULTS
RESULTS
Aseptic cup survivorship was 80% at 104 months (95% Confidence Interval 67.4-92.4). Overall implant survival was 73%. Major bone loss defects (Paprosky types 2c to 3b) were associated with a significantly higher rate of failure than minor defects (P = 0.002). There were eight cases of aseptic loosening (19.5%) and two of infection (4.9%). Previous surgeries, indication for acetabular revision, patient-related risk factors and use of megaprostheses did not significantly influence implant survival. The Harris Hip Score improved from a median of 40 (Interquartile range 31-45) to 82 (interquartile range 65-88) postoperative (P < 0.0001).
CONCLUSIONS
CONCLUSIONS
In summary, the use of porous tantalum metal implants in acetabular revision surgery achieves good to excellent short- term and mid-term functional results and an acceptable complication rate relative to the extent of defect and previous surgery. However, one should be aware of potential limitations of the implants in addressing large defects and discontinuity.
Identifiants
pubmed: 31113411
doi: 10.1186/s12891-019-2626-9
pii: 10.1186/s12891-019-2626-9
pmc: PMC6530026
doi:
Substances chimiques
Tantalum
6424HBN274
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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