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Revision total hip replacement using the cement-in-cement technique for the acetabular component : technique and results for 60 hips

Brogan, Kit , Charity, John , Sheeraz, Ahsan , Whitehouse, Sarah L., Timperley, A. John , Howell, Jonathan R. , & Hubble, Matthew J. W. (2012) Revision total hip replacement using the cement-in-cement technique for the acetabular component : technique and results for 60 hips. Journal of Bone and Joint Surgery : British Volume, 94-B(11), pp. 1482-1486.

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    Abstract

    The technique of femoral cement-in-cement revision is well established, but there are no previous series reporting its use on the acetabular side at the time of revision total hip arthroplasty.

    We describe the surgical technique and report the outcome of 60 consecutive cement-in-cement revisions of the acetabular component at a mean follow-up of 8.5 years (range 5-12 years). All had a radiologically and clinically well fixed acetabular cement mantle at the time of revision. 29 patients died. No case was lost to follow-up. The 2 most common indications for acetabular revision were recurrent dislocation (77%) and to compliment a femoral revision (20%).

    There were 2 cases of aseptic cup loosening (3.3%) requiring re-revision. No other hip was clinically or radiologically loose (96.7%) at latest follow-up. One case was re-revised for infection, 4 for recurrent dislocation and 1 for disarticulation of a constrained component. At 5 years, the Kaplan-Meier survival rate was 100% for aseptic loosening and 92.2% (95% CI; 84.8-99.6%) with revision for all causes as the endpoint.

    These results support the use of the cement-in-cement revision technique in appropriate cases on the acetabular side. Theoretical advantages include preservation of bone stock, reduced operating time, reduced risk of complications and durable fixation.

    Impact and interest:

    2 citations in Scopus
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    2 citations in Web of Science®

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    ID Code: 54486
    Item Type: Journal Article
    Keywords: cement-in-cement, cup, revision, total hip arthroplasty, acetabulum
    DOI: 10.1302/0301-620X.94B11.29415
    ISSN: 0301-620X
    Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > CLINICAL SCIENCES (110300) > Orthopaedics (110314)
    Divisions: Current > Schools > School of Chemistry, Physics & Mechanical Engineering
    Current > Institutes > Institute of Health and Biomedical Innovation
    Current > QUT Faculties and Divisions > Science & Engineering Faculty
    Copyright Owner: Copyright 2012 British Editorial Society of Bone and Joint Surgery
    Deposited On: 02 Nov 2012 12:03
    Last Modified: 07 Nov 2012 19:40

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