The Midterm Results of Revision Total Hip Arthroplasty in Cases with Acetabular Defects: A Single-Center Case Series

Abstract

Background: Revision total hip arthroplasty (RTHA) is one of the critical topics in the orthopedic surgery. In this single center case series, the revision treatment of cases with acetabular defects following total hip arthroplasty is reported.
Methods: A total of 25 patients with acetabular defects were enrolled in this case series held in Imam Hossein Hospital, Tehran, Iran. The mean follow-up of patients was three years (24 - 42 months). The illustrated data include a history of surgeries, underlying diseases, acetabular defect classification, surgery procedure, and pre- and post-surgery complications and managements, Harris hip score (HHS), leg length discrepancy (LLD).
Results: The mean age of patients was 63.8 ± 10.45 years. A total of 14 patients had two previous surgeries, eight patients had three surgeries, and three patients had four previous surgeries. Classification of bone loss using AAOS showed that four patients had grade III and 21 patients had grade IV acetabular bone loss. The RTHA was done using anti-protrusio in 12 patients and large cups in 13 patients. The mean Harris hip score was 22.16 before RTHA, which was 80.6 after revision surgery. Before the operation, the mean leg length discrepancy was 38.84 mm, which was corrected after surgery to an average of 3.56 mm.
Conclusions: Extensive evaluation of patients with acetabular defects before and during revision surgery leads to promising results. Larger studies evaluating the management strategy in patients with acetabular defects are needed.