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[Technique of implantation of a cementless press-fit cup in revisions with severe bone defects].

Abstract：

OBJECTIVE:Revision of loose cups of total hip arthroplasties. Implantation and solid fixation of a cementless press-fit cup to restore painless joint function. INDICATIONS:Loose cups of total hip arthroplasties. Reimplantation of a prosthetic cup after removal of an infected total hip arthroplasty. CONTRAINDICATIONS:Bone defects of the acetabulum precluding a press-fit fixation (at least three-surface fixation) of the cup. Persistent infection. SURGICAL TECHNIQUE:Exposure of the acetabulum using a standard approach. Removal of the loose cup. Cleaning of the ground with a spoon. Reaming of a new, deeper center of rotation in the acetabulum using a small reamer. Stepwise reaming of the acetabulum using increasing reamer sizes without pressure until sufficient bone contact at the rim is reached (at least three-surface fixation). Hammering in of a thin-walled cementless press-fit cup (e.g., AllofitStrade mark) of the next size as compared to the reamer chosen last to reach a 4-mm press-fit fixation. Additional screwing in of two to three cancellous screws into the os ilium. POSTOPERATIVE MANAGEMENT:Thrombosis prophylaxis, physiotherapy, gait training with partial loading of the limb at 10 kg for a period of 6 weeks. Then increased loading by 10 kg per week. RESULTS:52 cup exchanges using an AllofitStrade mark cup were clinically and radiologically analyzed over an average period of 35.8 +/- 8.8 months (26-53 months). The Harris Hip Score increased from a preoperative value of 46.4 to 87.3 points 2 years postoperatively. Two cups showed migration and one hip dislocated. Loosening has not been observed so far.

journal_name

Oper Orthop Traumatol

journal_title

Operative Orthopadie und Traumatologie

authors

Fink B,Grossmann A

doi

10.1007/s00064-008-1238-6

subject

Has Abstract

pub_date

2008-06-01 00:00:00

pages

157-67

issue

2

eissn

0934-6694

issn

1439-0981

journal_volume

20

pub_type

杂志文章

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