Cementless acetabular revision: past, present, and future. Revision total hip arthroplasty: the acetabular side using cementless implants.

BACKGROUND

Acetabular revision is probably the most difficult aspect of hip reconstructive surgery. Although the majority of acetabular revisions can be performed using an uncemented hemispherical acetabular device with ancillary fixation, patients with severe acetabular deficiencies and poor bone quality require more complex alternatives for revision. The limitations of traditional cementless acetabular implants has promoted the development of improved methods of fixation and revision techniques. Highly porous metals have been introduced for clinical use in arthroplasty surgery over the last decade. Their higher porosity and surface friction are ideal for acetabular revision, optimising biological fixation. The use of trabecular metal cups in acetabular revision has yielded excellent clinical results.

PURPOSE

This review focuses on the use of cementless implants for acetabular revision. The use of trabecular metal cups, augments, jumbo cups, oblong cups, cages, and structural grafting are also discussed.