Porous Metal acetabular components in revision total hip arthroplasty: ≥5-Year Follow-up of 24 Patients

Abstract

Introduction: Severe acetabular bone loss has been a major difficulty in revision total hip arthroplasty (THA). Porous metal acetabular revision system provides solution for insufficient host-bone contact. Methods: Twenty-four patients who underwent revision THA using Trabecular Metal (Zimmer) acetabular revision system were reviewed after minimum follow-up of 5 years. The most common causes of revision were aseptic loosening, polyethylene wear with osteolysis, and periprosthetic joint infection. Trabecular metal cup alone, trabecular metal cup with augment, and cup-cage construct were used in 12, 8, and 4 hips, respectively. Results: After a mean follow-up of 9 years (standard deviation 2.6, range 6-14 years), 23 (96%) patients had excellent outcomes in functional and radiological assessments. All patients had significant improvement in Harris Hip Score after operation. No acetabular component loosening was found. No re-revision surgery was performed for mechanical failure of acetabular component. One (4%) patient had asymptomatic insert wear without osteolysis. Two (8%) patients had periprosthetic joint infection, which was successfully treated with debridement, antibiotics, and implant retention. One (4%) patient had superficial wound infection, which was successfully treated with incision and drainage. Conclusion: A longer period of follow-up is needed to evaluate the long-term outcome of the use of porous metal acetabular shell. Our data suggest the use of porous metal acetabular shell to be considered a safe technique with excellent outcome to tackle the difficulty of massive bone loss during revision THA.