Using Porous Tantalum Uncemented Components to Manage Acetabular Defects and to Restore the Hip Center of Rotation in Revision Total Hip Arthroplasty: A Minimum Ten-Year Clinical and Radiological Study.

Abstract

Background: Managing acetabular defects and restoring the hip center of rotation in revision hip arthroplasty is considered a complex and challenging surgery. Among many existing options, porous tantalum components have shown favorable short-term (less than ten years) follow-up results. The present study aimed to describe clinical and radiographic outcomes in longer-term follow-up.

Methods: Between 2006 and 2013, 98 patients who underwent this surgical technique in our institute were clinically and radiographically reviewed. Re-revisions for aseptic loosening of the acetabular component were examined to consider the survivorship of the implant as the primary endpoint. The clinical outcome was measured using the Harris Hip Score (HHS). Radiological signs of osseointegration, radiolucency lines, acetabular stability, and position of the hip center of rotation (COR) were evaluated at the immediate postoperative and last follow-up radiographs.

Results: The cup survivorship was 96% at a mean follow-up of 14 years (range, 10 to 17). Global survivorship was 83.6% if any reason for re-revisions was considered as an endpoint. The most frequent complications were dislocation (13.7%) and infections (12%). Overall, 13 patients died, and 17 patients were lost to follow-up. There were 73 patients available for clinical and radiographic evaluation. The mean HHS was 81 (range, 39 to 100). More than 80% of hips showed radiological evidence of osseointegration, and no change was found in COR position at last follow-up radiographs.

Conclusion: The use of porous tantalum uncemented components to manage revision hip arthroplasty can be considered a favorable solution for managing acetabular defects and restoring the hip center of rotation with satisfactory clinical and radiological results in a long-term follow-up.