Trabecular metal augments in severe malignancy-associated acetabular bone loss

• Published in: Hip international 2023-07, Vol.33 (4), p.678-684
• Main Authors: Melnic, Christopher M, Salimy, Mehdi S, Hosseinzadeh, Shayan, Moverman, Michael A, Bedair, Hany S, Lozano-Calderón, Santiago A, Raskin, Kevin A
• Format: Article
• Language: English
• Subjects: Acetabulum - diagnostic imaging; Acetabulum - surgery; Arthroplasty, Replacement, Hip - adverse effects; Follow-Up Studies; Hip Prosthesis; Humans; Metals; Neoplasms - surgery; Prosthesis Failure; Reoperation; Retrospective Studies
• ISSN: 1120-7000; 1724-6067
• DOI: 10.1177/11207000221110787

Introduction: Acetabular reconstruction is a challenging problem in orthopaedic oncology, especially in extended defects (Paprosky Type 3A and Type 3B). In revision total hip arthroplasty (THA), 1 option is trabecular metal (TM) augments with a porous metal acetabular component. This study evaluated the use of TM augments in periacetabular malignant bone disease. Methods: 15 patients were identified from our institutional database from 2000 to 2020 with either Paprosky Type 3A or Type 3B acetabular bone loss due to periacetabular malignancies that underwent at least 1 complex THA reconstruction with TM augments. Postoperative complications were documented, and clinical and radiographic outcomes were analysed. Radiological loosening or revision of the acetabular component were defined as endpoints. Results: There were 7 primary and 8 metastatic cancer patients. 5 were Type 3A and 10 were Type 3B defects after tumour resection. The average follow-up time was 23.8 (range 1.5–47) months. 1 patient required revision for acetabular component loosening after 7 months from the initial implantation. An additional 4 patients required surgical intervention for infection, they had stable TM augments at latest follow-up. Conclusion: TM augments with a porous metal acetabular component may be an alternative to the traditional cemented constructs.