In the Journals

Revision THA with rigid construct yielded high rates of healing, stable fixation

Patients with unilateral pelvic discontinuity treated with revision total hip arthroplasty had improved survivorship and healing rates when surgeons used a reconstruction cage as an adjunct to an uncemented cup or in combination with structural allograft bone that bridged the discontinuity, according to results.

John Ryan Martin, MD, and colleagues reviewed preoperative, immediate postoperative and latest follow-up radiographs of 113 consecutive revision total hip arthroplasties (THAs) performed for the treatment of unilateral pelvic discontinuity to assess healing of the discontinuity, as well as acetabular component stability. Patients were treated with an uncemented cup with a posterior column plate, a cup-cage construct, an antiprotrusio cage with or without a posterior column plate or an uncemented cup alone.

Results showed implants had the best 5-year revision-free survivorship with a cup-cage construct (100%). The worst rates were with an uncemented cup with a posterior column plate (80%) and a cup alone (80%). Researchers noted 50% of the hips with an uncemented cup alone, 74% of hips with an uncemented cup and a posterior column plate, 74% of the hips with a cup-cage construct and 88% of the hips with an antiprotrusio cage construct had healing of discontinuity. Researchers found an overall complication rate of 26.5% and an improvement in the average Harris Hip score from 54 preoperatively to 69 postoperatively. – by Casey Tingle

Disclosures: Martin reports personal fees from Zimmer Biomet. Please see the full study for a list of all other authors’ relevant financial disclosures.

Patients with unilateral pelvic discontinuity treated with revision total hip arthroplasty had improved survivorship and healing rates when surgeons used a reconstruction cage as an adjunct to an uncemented cup or in combination with structural allograft bone that bridged the discontinuity, according to results.

John Ryan Martin, MD, and colleagues reviewed preoperative, immediate postoperative and latest follow-up radiographs of 113 consecutive revision total hip arthroplasties (THAs) performed for the treatment of unilateral pelvic discontinuity to assess healing of the discontinuity, as well as acetabular component stability. Patients were treated with an uncemented cup with a posterior column plate, a cup-cage construct, an antiprotrusio cage with or without a posterior column plate or an uncemented cup alone.

Results showed implants had the best 5-year revision-free survivorship with a cup-cage construct (100%). The worst rates were with an uncemented cup with a posterior column plate (80%) and a cup alone (80%). Researchers noted 50% of the hips with an uncemented cup alone, 74% of hips with an uncemented cup and a posterior column plate, 74% of the hips with a cup-cage construct and 88% of the hips with an antiprotrusio cage construct had healing of discontinuity. Researchers found an overall complication rate of 26.5% and an improvement in the average Harris Hip score from 54 preoperatively to 69 postoperatively. – by Casey Tingle

Disclosures: Martin reports personal fees from Zimmer Biomet. Please see the full study for a list of all other authors’ relevant financial disclosures.