Braunstein Doris, Greenberg Arieh, Chaudhry Faran, Daud Anser, Safir Oleg A, Gross Allan E, Kuzyk Paul R
Department of Orthopaedic Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada.
Department of Orthopaedic Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada; Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
J Arthroplasty. 2025 Mar;40(3):751-757. doi: 10.1016/j.arth.2024.09.004. Epub 2024 Sep 14.
Acetabular bone loss is a major challenge in the setting of revision total hip arthroplasty (THA). Porous tantalum augments have emerged as a viable solution to acetabular bone loss in revision THA. The purpose of this study was to evaluate the survivorship, clinical, and radiological outcomes of these implants.
We identified 104 augment implants from our retrospective chart review of revision THA from June 2003 to July 2013. Of these patients, 75 (72.1%) were women, the mean age at surgery was 66 years (range, 27 to 87), and the mean follow-up was 13.2 years (range, 0.25 to 18.2). Kaplan-Meier survival analysis was performed, with failure defined as revision for aseptic loosening of the acetabular reconstruction.
There was significant improvement in the Harris Hip Score from 40.0 to 77.3 (P < 0.001) and the Oxford Hip Score from 14.9 to 36.3 (P < 0.001). Survivorship for failure due to aseptic loosening was 98.8% (95% CI [confidence interval] 96.4 to 100) at 24 months with 60 hips at risk, and 90.4% (95% CI 83.0 to 97.8) at 60 and 120 months with 38 and 18 hips at risk, respectively. The overall number of complications was 34 (32.7%). Of these complications, 21 (20.2%) required repeat revision surgery. The revision rate due to aseptic loosening of the augment, infection, dislocation, aseptic loosening of the femoral component, reconstruction failure, and heterotopic ossification was seven (6.7%), five (4.8%), four (3.8%), two (1.9%), two (1.9%), and one (0.96%), respectively.
Treatment of acetabular defects during revision THA using porous tantalum augments provides acceptable implant survivorship and favorable clinical outcomes at mid-term (5 to 10 years) and long-term (> 10 years) follow-up.
髋臼骨缺损是翻修全髋关节置换术（THA）中的一项重大挑战。多孔钽增强物已成为翻修THA中髋臼骨缺损的一种可行解决方案。本研究的目的是评估这些植入物的生存率、临床和放射学结果。
通过对2003年6月至2013年7月翻修THA的回顾性病历审查，我们确定了104个增强植入物。在这些患者中，75名（72.1%）为女性，手术时的平均年龄为66岁（范围为27至87岁），平均随访时间为13.2年（范围为0.25至18.2年）。进行了Kaplan-Meier生存分析，失败定义为因髋臼重建无菌性松动而进行翻修。
Harris髋关节评分从40.0显著提高到77.3（P < 0.001），牛津髋关节评分从14.9提高到36.3（P < 0.001）。因无菌性松动导致失败的生存率在24个月时为98.8%（95%可信区间[CI] 96.4至100），有60个髋关节处于风险中；在60个月和120个月时分别为90.4%（95%CI 83.0至97.8），有38个和18个髋关节处于风险中。并发症总数为34例（32.7%）。在这些并发症中，21例（20.2%）需要再次翻修手术。因增强物无菌性松动、感染、脱位、股骨组件无菌性松动、重建失败和异位骨化导致的翻修率分别为7例（6.7%）、5例（4.8%）、4例（3.8%）、2例（1.9%）、2例（1.9%）和1例（0.96%）。
在翻修THA期间使用多孔钽增强物治疗髋臼缺损，在中期（5至10年）和长期（> 10年）随访中提供了可接受的植入物生存率和良好的临床结果。
