Middle term results of tantalum acetabular cups in total hip arthroplasty following pelvic irradiation

Objectives: The aim of this study was to evaluate the middle term cup survival, assess the functional implementation and the radiographic evolution of tantalum acetabular cups implanted on patients with a history of pelvic radiotherapy. Methods: From 2005 to 2013, we performed 12 THA replacements (4...

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Main Authors: Massimiliano De Paolis, Riccardo Zucchini, Carlo Romagnoli, Matteo Romantini, Federica Mariotti, Davide Maria Donati
Format: Article
Language:English
Published: AVES 2019-05-01
Series:Acta Orthopaedica et Traumatologica Turcica
Online Access:http://www.sciencedirect.com/science/article/pii/S1017995X18301718
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author Massimiliano De Paolis
Riccardo Zucchini
Carlo Romagnoli
Matteo Romantini
Federica Mariotti
Davide Maria Donati
author_facet Massimiliano De Paolis
Riccardo Zucchini
Carlo Romagnoli
Matteo Romantini
Federica Mariotti
Davide Maria Donati
author_sort Massimiliano De Paolis
collection DOAJ
description Objectives: The aim of this study was to evaluate the middle term cup survival, assess the functional implementation and the radiographic evolution of tantalum acetabular cups implanted on patients with a history of pelvic radiotherapy. Methods: From 2005 to 2013, we performed 12 THA replacements (4 males 8 females; mean age: 46.6 years (range 25–75)) on irradiated bone with Trabecular metal acetabular cups, 8 primary implants and 4 revision implants. The mean radiation dose delivered was 5500 cGy (range 3000 cGy–13,600 cGy). The mean follow-up was 68 months, ranging from 38 to 136. Postoperative follow-up time was assessed at 1, 3, 6 and 12 months, then annually. Double projection radiographs were requested at each control. Radiographic signs of loosening were investigated by X-rays looking for radiolucent lines. We used the Harris hip score for the clinical and functional evaluation. Results: To now none of the 12 patients in the series needed any revision surgery for aseptic loosening. In the revision group one patient have been revised for septic loosening, two patients have been treated by conservative procedure for hip dislocation. Post-operative Harris hip score improved from an average of 46 points to 85.3 points. At last follow-up we found only in one case radiographic signs of progressive lucent line, without clinical sign of failure. Conclusion: In a clinical setting, tantalum cup seems to provide a good stability due to the integration of the trabecular metal to the underline cancellous bone. The reported results, in agreement with literature data, propose the use of tantalum cups in irradiated bone. Level of evidence: Level IV, therapeutic study. Keywords: Hip, Arthroplasty, Uncemented cup, Tantalum, Radiotherapy, Tumor
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spelling doaj.art-97320fd0fbf5473198e05460317c3a412023-02-15T16:18:32ZengAVESActa Orthopaedica et Traumatologica Turcica1017-995X2019-05-01533165169Middle term results of tantalum acetabular cups in total hip arthroplasty following pelvic irradiationMassimiliano De Paolis0Riccardo Zucchini1Carlo Romagnoli2Matteo Romantini3Federica Mariotti4Davide Maria Donati5IRCCS Istituto Ortopedico Rizzoli, Bologna, ItalyCorresponding author.; IRCCS Istituto Ortopedico Rizzoli, Bologna, ItalyIRCCS Istituto Ortopedico Rizzoli, Bologna, ItalyIRCCS Istituto Ortopedico Rizzoli, Bologna, ItalyIRCCS Istituto Ortopedico Rizzoli, Bologna, ItalyIRCCS Istituto Ortopedico Rizzoli, Bologna, ItalyObjectives: The aim of this study was to evaluate the middle term cup survival, assess the functional implementation and the radiographic evolution of tantalum acetabular cups implanted on patients with a history of pelvic radiotherapy. Methods: From 2005 to 2013, we performed 12 THA replacements (4 males 8 females; mean age: 46.6 years (range 25–75)) on irradiated bone with Trabecular metal acetabular cups, 8 primary implants and 4 revision implants. The mean radiation dose delivered was 5500 cGy (range 3000 cGy–13,600 cGy). The mean follow-up was 68 months, ranging from 38 to 136. Postoperative follow-up time was assessed at 1, 3, 6 and 12 months, then annually. Double projection radiographs were requested at each control. Radiographic signs of loosening were investigated by X-rays looking for radiolucent lines. We used the Harris hip score for the clinical and functional evaluation. Results: To now none of the 12 patients in the series needed any revision surgery for aseptic loosening. In the revision group one patient have been revised for septic loosening, two patients have been treated by conservative procedure for hip dislocation. Post-operative Harris hip score improved from an average of 46 points to 85.3 points. At last follow-up we found only in one case radiographic signs of progressive lucent line, without clinical sign of failure. Conclusion: In a clinical setting, tantalum cup seems to provide a good stability due to the integration of the trabecular metal to the underline cancellous bone. The reported results, in agreement with literature data, propose the use of tantalum cups in irradiated bone. Level of evidence: Level IV, therapeutic study. Keywords: Hip, Arthroplasty, Uncemented cup, Tantalum, Radiotherapy, Tumorhttp://www.sciencedirect.com/science/article/pii/S1017995X18301718
spellingShingle Massimiliano De Paolis
Riccardo Zucchini
Carlo Romagnoli
Matteo Romantini
Federica Mariotti
Davide Maria Donati
Middle term results of tantalum acetabular cups in total hip arthroplasty following pelvic irradiation
Acta Orthopaedica et Traumatologica Turcica
title Middle term results of tantalum acetabular cups in total hip arthroplasty following pelvic irradiation
title_full Middle term results of tantalum acetabular cups in total hip arthroplasty following pelvic irradiation
title_fullStr Middle term results of tantalum acetabular cups in total hip arthroplasty following pelvic irradiation
title_full_unstemmed Middle term results of tantalum acetabular cups in total hip arthroplasty following pelvic irradiation
title_short Middle term results of tantalum acetabular cups in total hip arthroplasty following pelvic irradiation
title_sort middle term results of tantalum acetabular cups in total hip arthroplasty following pelvic irradiation
url http://www.sciencedirect.com/science/article/pii/S1017995X18301718
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