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[Technique of implantation of a cementless press-fit cup in revisions with severe bone defects].
- Source :
-
Operative Orthopadie und Traumatologie [Oper Orthop Traumatol] 2008 Jun; Vol. 20 (2), pp. 157-67. - Publication Year :
- 2008
-
Abstract
- Objective: Revision of loose cups of total hip arthroplasties. Implantation and solid fixation of a cementless press-fit cup to restore painless joint function.<br />Indications: Loose cups of total hip arthroplasties. Reimplantation of a prosthetic cup after removal of an infected total hip arthroplasty.<br />Contraindications: Bone defects of the acetabulum precluding a press-fit fixation (at least three-surface fixation) of the cup. Persistent infection.<br />Surgical Technique: Exposure of the acetabulum using a standard approach. Removal of the loose cup. Cleaning of the ground with a spoon. Reaming of a new, deeper center of rotation in the acetabulum using a small reamer. Stepwise reaming of the acetabulum using increasing reamer sizes without pressure until sufficient bone contact at the rim is reached (at least three-surface fixation). Hammering in of a thin-walled cementless press-fit cup (e.g., AllofitStrade mark) of the next size as compared to the reamer chosen last to reach a 4-mm press-fit fixation. Additional screwing in of two to three cancellous screws into the os ilium.<br />Postoperative Management: Thrombosis prophylaxis, physiotherapy, gait training with partial loading of the limb at 10 kg for a period of 6 weeks. Then increased loading by 10 kg per week.<br />Results: 52 cup exchanges using an AllofitStrade mark cup were clinically and radiologically analyzed over an average period of 35.8 +/- 8.8 months (26-53 months). The Harris Hip Score increased from a preoperative value of 46.4 to 87.3 points 2 years postoperatively. Two cups showed migration and one hip dislocated. Loosening has not been observed so far.
- Subjects :
- Aged
Aged, 80 and over
Bone Screws
Female
Follow-Up Studies
Humans
Male
Middle Aged
Postoperative Complications diagnostic imaging
Prosthesis Design
Prosthesis-Related Infections surgery
Radiography
Reoperation
Acetabulum surgery
Arthroplasty, Replacement, Hip methods
Hip Prosthesis
Postoperative Complications surgery
Prosthesis Failure
Subjects
Details
- Language :
- German
- ISSN :
- 0934-6694
- Volume :
- 20
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Operative Orthopadie und Traumatologie
- Publication Type :
- Academic Journal
- Accession number :
- 18535800
- Full Text :
- https://doi.org/10.1007/s00064-008-1238-6