Acetabulum, Bone, Harris Hip Score, Health, Hip Replacement, hip resurfacing, Journal of Bone and Joint Surgery, jumbo cup liner, jumbo hip liner, Medicine, NephewSmith, science, surgery, WOMAC, womac index
Jumbo cup in revision hip arthroplasty 53 cases with 84 months of follow-up
A. Nzokou, J.M. Laffosse, S. Diwanji, M. Lavigne, A.G. Roy, P-A. Vendittoli
Acetabular implant revision with bone defects can be challenging. We hypothesized that cementless jumbo cup (outer diameter ? 62mm in women and ? 66mm in men) is one of reliable technique to reconstruct acetabulum with satisfying radiological and clinical outcomes.
Material and Methods
Fifty-three consecutive acetabular revisions with cementless jumbo cup were assessed. Paprosky classification was used to qualify preoperative bone defects. Clinical outcomes were assessed by Harris Hip Score (HHS), WOMAC index and SF-12. Hip centre was assessed according to Pierchon’s criteria. The reconstructed hip center was considered as satisfying when located from -10 to + 10mm proximally (y axis) and/or medially (x axis) in comparison with ideal theoretical hip centre location.
At immediate postoperative evaluation, the mean abduction cup angle was 41.6° (26-54°), a satisfying hip centre positioning in 78% on x axis and in 71 % on y axis, in the remaining cases, we noted an improve implant positioning. At the last follow up (radiological data: 83.8 months (24-236) and clinical data: 91.3 months (27-246)), 6 cases were died and 4 were lost of follow up. The mean HHS was 83.2%, WOMAC 86%, SF-12: 46 physical and 53 mental. Complications were: 5 dislocations, 4 infections. No case required revision for aseptic loosening.
Jumbo cups appear as a reliable procedure to manage bone loss in acetabular revision. The complication rate is comparable with other reconstruction procedures. Cementless fixation and satisfying hip center restoration promote respectively the bone integration and allow an optimal biomechanical joint functioning.
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