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Beitragstitel Reconstruction of severe acetabular bone defects with dual mobility cup cemented into a Ganz reinforcement ring or a porous tantalum shell in revision THA: a comparative study
Beitragscode P26
  1. Claire-Anne Saugy Vortragender
  2. Alexander Antoniadis Lausanne University Hospital – CHUV
  3. Julien Wegrzyn CHUV & Université de Lausanne
Präsentationsform Poster
  • A04 - Hüfte
Different techniques of acetabular reconstruction during revision total hip arthroplasty (rTHA) were described in literature depending on the severity of acetabular bone defect. To reconstruct severe defects, the most common options include the use of a reinforcement device or a porous tantalum reconstruction shell in association with a cemented dual mobility cup (DMC). However, to our knowledge, no previous study compared acetabular reconstructions performed with these two techniques in rTHA associated with severe bone defects. Therefore, this monocentric study aimed to evaluate their indications and to compare them in terms of complications, survivorship and restoration of the hip center of rotation (CoR).

From 2012 to 2019, a continuous series of 81 rTHA with acetabular reconstruction performed with a DMC cemented into a Ganz reinforcement ring (41 rTHA) or a Trabecular Metal (TM) reconstruction shell (40 rTHA) was prospectively included in our registry and retrospectively analyzed by two independent surgeons at latest follow-up. The inclusion criteria were Paprosky IIB to III A acetabular bone defects. The Paprosky IIIB defects leading to pelvic discontinuity were excluded. Restoration of the CoR was evaluated using the Pierchon’s method.

No difference was observed in terms of indications for rTHA. The severity of acetabular defect was lower in the Ganz group (p-value < 0.01 (Χ2)).
After a mean follow-up of 5 years, 18 % of the hips sustained new revision(s). No aseptic loosening happened in the TM group, 7 in the Ganz group. No difference was observed in terms of infection and instability.
The CoR’s restoration was accurate in both groups apart from the vertical CoR in Paprosky IIIA defects (mean cranialization of 11 mm in the TM group / 11 rTHA concerned vs. 7 mm in the Ganz group / 7 rTHA concerned).

These two techniques are both validated for moderate to severe acetabular bone defect reconstruction during rTHA. However, the risk of aseptic loosening was higher with the Ganz technique while the severity of acetabular bone defect to be reconstructed was lower than that managed with the TM technique. Both techniques ensured an accurate restoration of the hip CoR. However, cranialization of the CoR was more frequent with the TM reconstruction shell technique in acetabular reconstruction for Paprosky IIIA bone defects, mainly explained by the “jumbo cup” effect related to this reconstruction technique.