Journal of Orthopedics 2023 May-Aug; 15(2):57-66
REVIEW
CLINICAL AND RADIOLOGICAL RESULTS OF SEVERE ACETABULAR BONE DEFECTS IN REVISION TOTAL HIP ARTHROPLASTY USING MODULAR POROUS METAL COMPONENTS: A NARRATIVE REVIEW
S. Rizzo1, M. Grasso1, A. Benedetto1, M. Smaldino1, G. Solarino1 and A. Pannella2
1Orthopaedics University of Bari “Aldo Moro”- AOU Policlinico Consorziale, Department of Translational Biomedicine and Neuroscience, Orthopaedic &Trauma Unit, Bari, Italy;
2Orthopaedics Unit, Don Tonino Bello Hospital, Molfetta, Italy
Corresponding author:
Stefano Rizzo, MD
School of Medicine,
University of Bari “Aldo Moro”- AOU Policlinico Consorziale,
Department of Translational Biomedicine and Neuroscience,
Orthopaedic &Trauma Unit Policlinico,
Piazza Giulio Cesare 11,
Bari 70124, Italy
e-mail: dr.stefanorizzo@gmail.com
ABSTRACT
The incidence of total hip arthroplasty (THA) revisions is expected to rise significantly in the future, due to the population’s greater life expectancy and the decreasing age of patients undergoing primary THA. Several alternative surgical techniques have been suggested depending on the extent and kind of acetabular bone loss. The aim of this review is to analyze the clinical and radiological mid-term and long-term outcomes of Paprosky II and III acetabular bone defects treated with modular porous metal components and their survivorship rate. We reviewed 15 articles in the literature based on the treatment of acetabular revisions. The literature review was conducted using electronic databases from their dates of inception. In severe acetabular bone defects, especially those classified as Paprosky II e III, metallic materials are proposed for their biomechanical properties to ensure primary fixation by a roughness effect. Modular porous metal components represent a promising type of implant, but the literature is controversial, and few articles show mid-term follow-up. The studies reviewed demonstrate an excellent result in follow-up but also reported complications and limitations; therefore, the use of certain implants and specific surgical techniques must be performed according to the severity of the bone loss and the patient’s clinical conditions.
KEYWORDS: total hip arthroplasty, revision, bone defect, trabecular metal, Paprosky