Clinical and radiological survivorship of the Thackray cross plate with rim reinforcement ring for cemented acetabular r
- PDF / 1,127,643 Bytes
- 11 Pages / 595.276 x 790.866 pts Page_size
- 45 Downloads / 159 Views
HIP ARTHROPLASTY
Clinical and radiological survivorship of the Thackray cross plate with rim reinforcement ring for cemented acetabular revision Leonidas Roumeliotis1 · Saadallah G. Haidar1 · Christopher M. Jordan1,2 · Jamie T. Griffiths1 · Toby W. Briant‑Evans1 · Geoffrey J. Stranks1 Received: 1 June 2020 / Accepted: 16 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Introduction Acetabular component revision surgery can be a challenging task due to the encountered bone defects. Both cemented and uncemented techniques are described. We report on the survivorship of the Thackray cross plate with rim reinforcement ring for cemented acetabular revision. Patients and methods This is a retrospective case series of all patients treated with the implant with a minimum follow-up of 2 years. Acetabular defects were characterized according to the Paprosky classification. Data on potential risk factors for failure of the construct as well as the Oxford Hip Score (OHS) were collected. Kaplan–Meier survival analysis with radiographic aseptic loosening or revision for aseptic loosening as the end point was performed. Results From 2000 to 2017, 35 revisions in 18 male and 17 female patients with an average age of 72 years were included. Bone allograft was used in 26 cases and additional implants (medial or supero-lateral mesh) in 13. Seven patients have deceased and the fate of all revisions is known. At an average clinical follow-up of 9.7 (2.6 to 19.6) years, there were no further re-revisions for construct failure. Five hips have demonstrated radiological evidence of aseptic loosening. Radiologically loose components were associated with more severe grades of acetabular bone defects (Paprosky Type 3) (60% vs 3%, p = 0.006). Kaplan–Meier survival analysis demonstrates 79.8% overall survivorship at 7 years. Survivorship for Type 2 defects was significantly higher compared to Type 3 (90% vs 0% at 7 years, Logrank test p = 0.002, Cox proportional hazards p = 0.03). The final median OHS was 38 (12–48) and was not affected by component loosening. Conclusion This is a cost-effective device that protects the underlying bone graft (81% complete remodeling) and prevents subsidence of the cemented cup (2 mm on average). It should be used with caution in high-grade defects and perhaps not advised. Keywords Hip replacement · Acetabular revision · Reinforcement ring · Survival analysis · Aseptic loosening
Introduction Total hip arthroplasty is considered one of the most successful operations in orthopaedic surgery [1]. The number of procedures performed annually is expected to rise and * Leonidas Roumeliotis [email protected] 1
Department of Trauma and Orthopaedics, Basingstoke and North Hampshire Hospital, Hampshire Hospitals NHS Foundation Trust, Aldermaston Road, Basingstoke RG24 9NA, Hampshire, UK
Department of Trauma and Orthopaedics, St Mary’s Hospital, Imperial College Healthcare NHS Trust, London, UK
2
potentially cause a corresponding increase in revision surgery [2]
Data Loading...
