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The role of component positions in revision hip arthroplasty; Minimum 5-year follow-up

Fahri Emre, Erkan Sabri Ertas, Murat Bozkurt.




Abstract

This study aimed to investigate the effect of distance between the femoral head and predicted hip rotation center on clinical and radiological survival of the acetabular implants (Jumbo cups and acetabular cages) retrospectively in patients who had revision hip arthroplasties. The retrospective study included a total of 52 consecutive patients (16 in acetabular cage group I, 36 in Jumbo cup group II). Radiological evaluation was performed by assessing the hip rotation center, polyethylene wear, lateral offset of the hip, and the migration of acetabular component on pelvis AP radiographs. Harris Hip Score (HHS) was used to assess the clinical evaluation at one, three, six, twelve months, and each year. The mean postoperative HHS at the last clinical assessment was 67.0±12.9 in group I and 68.2±11.9 in group II, respectively. The change in the hip rotation center did not affect the HSS scores between the groups (p>0.05), whereas acetabular cup migration and lateral offset comparison between groups were found statistically significant (p: 0.007). There was no significant correlation between lateral offset and acetabular implant migration (p>0.05), however, there was a negative correlation in comparison between lateral offset and polyethylene wear. Our study results suggest that both jumbo porous-coated acetabular components with screw fixation or reinforcement cages can be used in hips with notable bone loss. However, it is concluded that the shorter offset had higher liner wear which may contribute to a higher revision rate after revision hip arthroplasty.

Key words: Revision hip arthroplasty, Jumbo cup, acetabular reconstruction cage, center of hip rotation, lateral femoral offset, polyethylene wear






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