Outcome of Porous Tantalum Acetabular Components for Paprosky Type 3 and 4 Acetabular Defects

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Abstract

Porous tantalum acetabular implants provide a potential solution for dealing with significant acetabular bone loss. This study reviews 24 acetabular revisions using tantalum implants for Paprosky type 3 and 4 defects. The mean Harris Hip Score improved from 35 ± 19 (range, 4–71) to 88 ± 14 (range, 41–100), p < 0.0001. Postoperative radiographs showed radiolucent lines in 14 hips with a mean width of 1.3 ± 1.0 mm (range, 0.27–4.37 mm). No gaps enlarged and 71% of them disappeared at a mean of 13 ± 10 months (range, 3–29 months). At a mean follow-up of 37 ± 14 months (range, 24–66 months), 22 reconstructions showed radiograpic evidence of osseointegration (92%). The two failures were secondary to septic loosening. When dealing with severe acetabular bone loss, porous tantalum acetabular components show promising short-term results.

Section snippets

Materials and Methods

Between 2005 and 2010, 96 acetabular revisions using tantalum components were performed at our institution. A retrospective review of these cases showed 36 hips in 36 patients had acetabula with Paprosky type 3 or 4 defects [18]. Twenty-six hips were classified with Paprosky type 3a defects, 8 hips were classified with Paprosky type 3b defects, and two hips as Paprosky type 4 defects. We excluded minor bone defects classified as Paprosky types 1 and 2, as well as patients with less than 2 years

Results

A total of 36 revision THAs classified as having a Paprosky type 3 or 4 defects were performed using porous tantalum acetabular implants between 2005 and 2010. Of these revision cases, 24 hips had a minimum of two years of follow-up or needed revision and are reported in this study. Of the 12 patients that did not have a minimum of 2 years of follow-up, 6 patients had 12 month postoperative radiographs which showed radiographic evidence of osseointegration of the acetabular component. The other 6

Discussion

Traditional porous-coated hemispherical implants (titanium alloy and cobalt chromium alloy) provide an effective solution in most revision THAs where adequate bone stock is available to support the acetabular component and allow for bone ingrowth 11., 22., 23.. However, severe acetabular bony deficiency can compromise both the biologic potential and the ability to obtain mechanical stability needed to allow for reliable osseointegration of the acetabular component. Options available to deal

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    The Conflict of Interest statement associated with this article can be found at http://dx.doi.org/10.1016/j.arth.2013.12.002.

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