Are porous tantalum cups superior to conventional reinforcement rings?: A retrospective cohort study of 207 acetabular revisions
Background and purpose — Porous tantalum cups have been introduced as an alternative to various reinforcement rings in revision hip surgery. We hypothesized that porous tantalum cups would be superior to Müller acetabular roof reinforcement rings (MARRs) in revision hip surgery with re-revision for...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Medical Journals Sweden
2017-01-01
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| Series: | Acta Orthopaedica |
| Online Access: | http://dx.doi.org/10.1080/17453674.2016.1248315 |
| _version_ | 1798018281923149824 |
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| author | Anders Brüggemann Erik Fredlund Hans Mallmin Nils P Hailer |
| author_facet | Anders Brüggemann Erik Fredlund Hans Mallmin Nils P Hailer |
| author_sort | Anders Brüggemann |
| collection | DOAJ |
| description | Background and purpose — Porous tantalum cups have been introduced as an alternative to various reinforcement rings in revision hip surgery. We hypothesized that porous tantalum cups would be superior to Müller acetabular roof reinforcement rings (MARRs) in revision hip surgery with re-revision for aseptic loosening as the primary outcome measure. Patients and methods — 207 hips operated with either a porous tantalum cup (TM cup, n = 111) or a MARR (n = 96) at index procedure were identified in our local arthroplasty register. Acetabular defects were classified according to Paprosky. There were 96 men and 111 women with a median age of 71 (35–95) years, presenting acetabular defect size type I in 39 cases, IIA in 22, IIB in 27, IIC in 43, IIIA in 32, and IIIB in 37 cases. Analysis of medical records identified all patients with subsequent re-revision and reasons for re-revisions. Kaplan-Meier survival functions were used to estimate implant survival. Results — With re-revision for aseptic loosening as the endpoint, the 6-year unadjusted cumulative survival was 97% (95% CI: 94–100) for TM cups and 96% (CI: 92–100) for MARR (p = 0.6). Using re-revision for any reason as the endpoint, 6-year survival was 87% (CI: 81–94) for TM cups and 95% (CI: 90–99) for MARR (p = 0.06). The main reason for re-revision in the TM group was dislocation (n = 10), followed by loosening (n = 3), whereas the main reason for re-revision in the MARR group was aseptic loosening (n = 8). Duration of the index procedure and perioperative blood loss were lower in the TM group. Interpretation — Both TM and MARR lead to good 6-year results in acetabular revision surgery. The methods differ in their respective failure mechanisms. We conclude that TM cups are a valuable treatment option in acetabular revision surgery, but the reasons underlying dislocations after the use of TM cups must be analyzed further. |
| first_indexed | 2024-04-11T16:21:30Z |
| format | Article |
| id | doaj.art-c48e2798ad6742dda89e6de392b23ba7 |
| institution | Directory Open Access Journal |
| issn | 1745-3674 1745-3682 |
| language | English |
| last_indexed | 2024-04-11T16:21:30Z |
| publishDate | 2017-01-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Acta Orthopaedica |
| spelling | doaj.art-c48e2798ad6742dda89e6de392b23ba72022-12-22T04:14:22ZengMedical Journals SwedenActa Orthopaedica1745-36741745-36822017-01-01881354010.1080/17453674.2016.12483151248315Are porous tantalum cups superior to conventional reinforcement rings?: A retrospective cohort study of 207 acetabular revisionsAnders Brüggemann0Erik Fredlund1Hans Mallmin2Nils P Hailer3Institute of Surgical Sciences, Uppsala University HospitalInstitute of Surgical Sciences, Uppsala University HospitalInstitute of Surgical Sciences, Uppsala University HospitalInstitute of Surgical Sciences, Uppsala University HospitalBackground and purpose — Porous tantalum cups have been introduced as an alternative to various reinforcement rings in revision hip surgery. We hypothesized that porous tantalum cups would be superior to Müller acetabular roof reinforcement rings (MARRs) in revision hip surgery with re-revision for aseptic loosening as the primary outcome measure. Patients and methods — 207 hips operated with either a porous tantalum cup (TM cup, n = 111) or a MARR (n = 96) at index procedure were identified in our local arthroplasty register. Acetabular defects were classified according to Paprosky. There were 96 men and 111 women with a median age of 71 (35–95) years, presenting acetabular defect size type I in 39 cases, IIA in 22, IIB in 27, IIC in 43, IIIA in 32, and IIIB in 37 cases. Analysis of medical records identified all patients with subsequent re-revision and reasons for re-revisions. Kaplan-Meier survival functions were used to estimate implant survival. Results — With re-revision for aseptic loosening as the endpoint, the 6-year unadjusted cumulative survival was 97% (95% CI: 94–100) for TM cups and 96% (CI: 92–100) for MARR (p = 0.6). Using re-revision for any reason as the endpoint, 6-year survival was 87% (CI: 81–94) for TM cups and 95% (CI: 90–99) for MARR (p = 0.06). The main reason for re-revision in the TM group was dislocation (n = 10), followed by loosening (n = 3), whereas the main reason for re-revision in the MARR group was aseptic loosening (n = 8). Duration of the index procedure and perioperative blood loss were lower in the TM group. Interpretation — Both TM and MARR lead to good 6-year results in acetabular revision surgery. The methods differ in their respective failure mechanisms. We conclude that TM cups are a valuable treatment option in acetabular revision surgery, but the reasons underlying dislocations after the use of TM cups must be analyzed further.http://dx.doi.org/10.1080/17453674.2016.1248315 |
| spellingShingle | Anders Brüggemann Erik Fredlund Hans Mallmin Nils P Hailer Are porous tantalum cups superior to conventional reinforcement rings?: A retrospective cohort study of 207 acetabular revisions Acta Orthopaedica |
| title | Are porous tantalum cups superior to conventional reinforcement rings?: A retrospective cohort study of 207 acetabular revisions |
| title_full | Are porous tantalum cups superior to conventional reinforcement rings?: A retrospective cohort study of 207 acetabular revisions |
| title_fullStr | Are porous tantalum cups superior to conventional reinforcement rings?: A retrospective cohort study of 207 acetabular revisions |
| title_full_unstemmed | Are porous tantalum cups superior to conventional reinforcement rings?: A retrospective cohort study of 207 acetabular revisions |
| title_short | Are porous tantalum cups superior to conventional reinforcement rings?: A retrospective cohort study of 207 acetabular revisions |
| title_sort | are porous tantalum cups superior to conventional reinforcement rings a retrospective cohort study of 207 acetabular revisions |
| url | http://dx.doi.org/10.1080/17453674.2016.1248315 |
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