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German Congress of Orthopaedics and Traumatology (DKOU 2016)

25.10. - 28.10.2016, Berlin

Titanium Augmentation Combined With Cemented Cup For Acetabular Bone Defect In Revision THA

Meeting Abstract

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  • presenting/speaker Hirotake Yo - Osaka Saiseikai Nakatsu Hospital, Osaka, Japan
  • Hirotsugu Ohashi - Osaka Saiseikai Nakatsu Hospital, Osaka, Japan
  • Tessyu Ikawa - Osaka Saiseikai Nakatsu Hospital, Osaka, Japan
  • Ryo Sugama - Osaka Saiseikai Nakatsu Hospital, Osaka, Japan

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2016). Berlin, 25.-28.10.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocPO15-587

doi: 10.3205/16dkou588, urn:nbn:de:0183-16dkou5888

Published: October 10, 2016

© 2016 Yo et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objectives: Objectives: Large acetabular defects can be reconstructed with various methods depending on size and location of the defect. We reported the usefulness of a new material titanium augment (Regenerex Augment; Biomet, Warsaw, IN) as a substitute of bone grafting. The purpose of this study was to evaluate (1) the radiographic results of osteointegration between acetabular and augment, position of the hip center after operation. (2) the clinical results assessed with Japanese Orthopaedic Score(JOA score). (3) assess complications related to the revision surgery.

Methods: Methods: We prospectively followed our 26 revisionTHA cases in whom we reconstructed the acetabulum with a regenerex titanium augment combined with a cemented shell from April 2011 to October 2015. Thare were 1 men and 25 women with an average age of 74 years. All 26 cases were followed an average of 32 months.

The initial diagnosis at the time of the primary THA for the 26 patients was DDH in 21 patients, femoral neck fracture in 4 patients, avascular necrosis of the femoral head in 1 patient.

All defects were classified by radiographic according to Paprosky classification. We performed regenerex titanium augment reconstruction in cases which belong to Paprosky 2A-3B. 18 defects were classified as Type3A, two as Type3B, two as Type 2B, four as Type 2A.

The need for an augment was anticipated based on preoperative templating of A-P view radiographs.

We template the cup followed by commonly used 50% rule for cup-host-bone surface contact. We obtained follow up radiographs postoperatively, at 1,3,6 months and then annually.

Postoperative complication was also assessed. Preoperative and postoperative height of hip center was measured by radiographs.

We used radiographic signs of osseointegration described by Moore et al.

Activity of daily living was measured with JOA Score.

Results: At an average of 32 months follow up, no patient required further surgery for aseptic loosening.

At the time of the latest follow up , 21 of the 26 acetabular reconstructions showed radiographic sign of osseointegration.

No major complication related to the revision surgery occurred.

Preoperatively, the hip center was located a mean of 45.6 mm above the interteardrop line.

Postoperatively, the hip center for these patients was located on average 27.3 mm above the interteardrop line.

Two patients had a high hip center of more than 35 mm postoperatively.

ADL parameters (JOA score) improved from 57 preoperatively to 83 postpoperatively.

Conclusions: As the results of the limitations and inconsistent results reported with conventional methods, regenerex titanium augment appears to be useful.

The mid term results with titanium augments are promising and longer follow up is required.