CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2019; 54(04): 471-476
DOI: 10.1055/s-0039-1693047
Artigo Original | Original Article
Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revnter Publicações Ltda Rio de Janeiro, Brazil

Recovery of the Hip Rotation Center with Tantalum in Revision Arthroplasty[*]

Article in several languages: português | English
1   Hospital Madre Teresa, Belo Horizonte, MG, Brasil
,
Victor Atsushi Kasuya Barbosa
1   Hospital Madre Teresa, Belo Horizonte, MG, Brasil
,
Lincoln Paiva Costa
1   Hospital Madre Teresa, Belo Horizonte, MG, Brasil
,
Euler de Carvalho Guedes
1   Hospital Madre Teresa, Belo Horizonte, MG, Brasil
,
Carlos César Vassalo
1   Hospital Madre Teresa, Belo Horizonte, MG, Brasil
› Author Affiliations
Further Information

Publication History

14 March 2018

21 August 2018

Publication Date:
20 August 2019 (online)

Abstract

Objective The objective of the present study is to evaluate the restoration capacity of the hip anatomic rotation center with the use of acetabular tantalum cups, associated or not with addition wedges.

Methods Retrospective analysis of patients undergoing hip arthroplasty revision using tantalum between June 2013 and April 2017. The abduction angle of the acetabular component and the horizontal and vertical distances of the component to the center of anatomical rotation of the hip were evaluated. The measurements were made through baseline radiographs performed in the preoperative period and at the last follow-up visit.

Results A sample of 21 patients was obtained, 11 (52%) men and 10 (48%) women, with a mean age of 62 ± 13 years old. The mean abduction angle of the acetabular cup decreased from 48.76° ± 13.88 ° in the preoperative period to 38.52° ± 10.08 ° in the postoperative period, and this difference was statistically significant (p = 0.001). The distances from the center of rotation of the prosthesis relative to the center of anatomical rotation of the hip were also lower after revision surgery with tantalum. The mean horizontal distance of 12.74 ± 10.59 mm was reduced to 7.11 ± 4.84 mm, and the mean vertical distance was reduced from 14.79 ± 10.05 mm to 4.89 ± 6.21 mm, and these reductions were statistically significant (p < 0.001).

Conclusion Hip arthroplasty revision with tantalum cups, associated or not with addition wedges, significantly recovered the anatomical rotation center of the hip.

* Work performed at the Hospital Madre Teresa, Belo Horizonte, MG, Brazil.


 
  • Referências

  • 1 Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am 2007; 89 (04) 780-785
  • 2 Gwam CU, Mistry JB, Mohamed NS, Thomas M, Bigart KC, Mont MA. , et al. Current Epidemiology of Revision Total Hip Arthroplasty in the United States: National Inpatient Sample 2009 to 2013. J Arthroplasty 2017; 32 (07) 2088-2092
  • 3 Paprosky WG, Magnus RE. Principles of bone grafting in revision total hip arthroplasty. Acetabular technique. Clin Orthop Relat Res 1994; (298) 147-155
  • 4 Lachiewicz PF, Soileau ES. Fixation, survival, and dislocation of jumbo acetabular components in revision hip arthroplasty. J Bone Joint Surg Am 2013; 95 (06) 543-548
  • 5 Schreurs BW, Keurentjes JC, Gardeniers JW, Verdonschot N, Slooff TJ, Veth RP. Acetabular revision with impacted morsellised cancellous bone grafting and a cemented acetabular component: a 20- to 25-year follow-up. J Bone Joint Surg Br 2009; 91 (09) 1148-1153
  • 6 Mäkinen TJ, Kuzyk P, Safir OA, Backstein D, Gross AE. Role of cages in revision arthroplasty of the acetabulum. J Bone Joint Surg Am 2016; 98 (03) 233-242
  • 7 Mäkinen TJ, Fichman SG, Watts E, Kuzyk PR, Safir OA, Gross AE. The role of cages in the management of severe acetabular bone defects at revision arthroplasty. Bone Joint J 2016; 98-B (1, Suppl A): 73-77
  • 8 Laaksonen I, Lorimer M, Gromov K, Rolfson O, Mäkelä KT, Graves SE. , et al. Does the risk of rerevision vary between porous tantalum cups and other cementless designs after revision hip arthroplasty?. Clin Orthop Relat Res 2017; 475 (12) 3015-3022
  • 9 Kosashvili Y, Backstein D, Safir O, Lakstein D, Gross AE. Acetabular revision using an anti-protrusion (ilio-ischial) cage and trabecular metal acetabular component for severe acetabular bone loss associated with pelvic discontinuity. J Bone Joint Surg Br 2009; 91 (07) 870-876
  • 10 Jenkins DR, Odland AN, Sierra RJ, Hanssen AD, Lewallen DG. Minimum five-year outcomes with porous tantalum acetabular cup and augment construct in complex revision total hip arthroplasty. J Bone Joint Surg Am 2017; 99 (10) e49
  • 11 Konan S, Duncan CP, Masri BA, Garbuz DS. Porous tantalum uncemented acetabular components in revision total hip arthroplasty: a minimum ten-year clinical, radiological and quality of life outcome study. Bone Joint J 2016; 98-B (06) 767-771
  • 12 Bobyn JD, Stackpool GJ, Hacking SA, Tanzer M, Krygier JJ. Characteristics of bone ingrowth and interface mechanics of a new porous tantalum biomaterial. J Bone Joint Surg Br 1999; 81 (05) 907-914
  • 13 Bobyn JD, Poggie RA, Krygier JJ, Lewallen DG, Hanssen AD, Lewis RJ. , et al. Clinical validation of a structural porous tantalum biomaterial for adult reconstruction. J Bone Joint Surg Am 2004; 86-A (Suppl. 02) 123-129
  • 14 Paprosky WG, Perona PG, Lawrence JM. Acetabular defect classification and surgical reconstruction in revision arthroplasty. A 6-year follow-up evaluation. J Arthroplasty 1994; 9 (01) 33-44
  • 15 Pagnano W, Hanssen AD, Lewallen DG, Shaughnessy WJ. The effect of superior placement of the acetabular component on the rate of loosening after total hip arthroplasty. J Bone Joint Surg Am 1996; 78 (07) 1004-1014
  • 16 Bicanic G, Delimar D, Delimar M, Pecina M. Influence of the acetabular cup position on hip load during arthroplasty in hip dysplasia. Int Orthop 2009; 33 (02) 397-402
  • 17 Liebs TR, Nasser L, Herzberg W, Rüther W, Hassenpflug J. The influence of femoral offset on health-related quality of life after total hip replacement. Bone Joint J 2014; 96-B (01) 36-42
  • 18 Cassidy KA, Noticewala MS, Macaulay W, Lee JH, Geller JA. Effect of femoral offset on pain and function after total hip arthroplasty. J Arthroplasty 2012; 27 (10) 1863-1869
  • 19 Jolles BM, Zangger P, Leyvraz PF. Factors predisposing to dislocation after primary total hip arthroplasty: a multivariate analysis. J Arthroplasty 2002; 17 (03) 282-288
  • 20 Patil S, Bergula A, Chen PC, Colwell Jr CW, D'Lima DD. Polyethylene wear and acetabular component orientation. J Bone Joint Surg Am 2003; 85-A (04) (Suppl. 04) 56-63
  • 21 Kennedy JG, Rogers WB, Soffe KE, Sullivan RJ, Griffen DG, Sheehan LJ. Effect of acetabular component orientation on recurrent dislocation, pelvic osteolysis, polyethylene wear, and component migration. J Arthroplasty 1998; 13 (05) 530-534
  • 22 Kim DH, Cho SH, Jeong ST, Park HB, Hwang SC, Park JS. Restoration of the center of rotation in revision total hip arthroplasty. J Arthroplasty 2010; 25 (07) 1041-1046
  • 23 Asayama I, Chamnongkich S, Simpson KJ, Kinsey TL, Mahoney OM. Reconstructed hip joint position and abductor muscle strength after total hip arthroplasty. J Arthroplasty 2005; 20 (04) 414-420
  • 24 Delp SL, Maloney W. Effects of hip center location on the moment-generating capacity of the muscles. J Biomech 1993; 26 (4-5): 485-499
  • 25 García-Rey E, García-Cimbrelo E. Abductor biomechanics clinically impact the total hip arthroplasty dislocation rate: a prospective long-term study. J Arthroplasty 2016; 31 (02) 484-490
  • 26 Abolghasemian M, Tangsataporn S, Sternheim A, Backstein D, Safir O, Gross AE. Combined trabecular metal acetabular shell and augment for acetabular revision with substantial bone loss: a mid-term review. Bone Joint J 2013; 95-B (02) 166-172