Abstract
Failed ingrowth and subsequent separation of revision acetabular components from the inferior hemi-pelvis constitutes a primary mode of failure in revision total hip arthroplasty (THA). Few studies have highlighted other techniques than multiple screws and an ischial flange or hook of cages to reinforce the inferior fixation of the acetabular components, nor did any authors report the use of porous metal augments in the ischium and/or pubis to reinforce inferior fixation of the acetabular cup.
The aims of this study were to introduce the concept of inferior extended fixation into the ischium and/or pubis during revision total hip arthroplasty, and to answer the following questions: (1) what are early clinical outcomes using inferior extended fixation and (2) what are the radiographic outcomes of hips revised with inferior extended fixation?
Patients who underwent revision THA utilizing the surgical technique of inferior extended fixation with porous metal augments secured in the ischium and/or pubis in a single institution from 2014 to 2016 were reviewed. Twenty-four patients were initially identified, and 16 patients were included based on the criteria of minimum 18 months clinical and radiographic follow-up.
The median HHS, as well as the SF-12 physical and mental components improved significantly at the latest follow-up (p<0.001). The WOMAC global score decreased significantly at the latest follow-up (p<0.001). All constructs were considered to have obtained bone ingrowth fixation.
Early follow-up of patients reconstructed with porous metal augments using the inferior extended fixation surgical technique demonstrated satisfactory clinical outcomes, restoration of the center of rotation and adequate biological fixation.
