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General Orthopaedics

THE JUMBO CUP: CEMENTLESS SOLUTION FOR ACETABULAR BONE LOSS

The Current Concepts in Joint Replacement (CCJR) Spring 2018 Meeting, Las Vegas, NV, USA, 20–23 May 2018.



Abstract

Hemispheric, porous-ingrowth revision acetabular components (generally with multiple screw fixation) have demonstrated versatility and durability over 25 years. Jumbo cups (minimum diameter of 62mm in women, 66mm in men, or 10mm larger than the normal contralateral acetabulum) are utilised in the majority of revisions with acetabular bone loss, with or without bone grafting, or other augmentation. The popularity of jumbo cups is due to their relative ease of use and the reliability of the result. With up to 20-year follow-up, and failure defined as cup revision for aseptic loosening or radiographic evidence of loosening, implant survival was 97.3% (95% confidence interval, 89.6% to 99.3%) at ten years and 82.8% (95% CI, 59% to 97.6%) at fifteen years. Twenty-year survivorship with 88% free from aseptic loosening of the metal acetabular component has been reported. Instability is decreased in association with larger diameter bearings. Revisions associated with wear of non-crosslinked polyethylene increased in the second decade. Crosslinked polyethylene and ultra-porous materials will likely increase both the durability and the utility of jumbo cups.