The Role Of Big Size Biological Cups Used In Acetabulum Defects Of The Hip Revision Procedures

Objective: To investigate the application of big size biological acetabular cups for noninfectious acetabulum defects after total hip arthroplasty(THA).Method: The clinical data of 27 patients who were diagnosed as acetabular deficiencies of Paprosky type after THA from March 2008 to Nine 2015 were retrospectively analyzed.There were 11 males and 16 females,whose average age was 64.58 years old(range:42-77 years).As to the reason,there were 21 cases caused by as aseptic loosening,4 cases by the central dislocation and 2 cases by severe wear of the artificial prosthesis.Primary and unilateral revision was performed on all the patients.Cemented acetabular prostheses were used in11 cases,cementless acetabular prostheses in 16 case.According to the Paprosky acetabular defect classification,there were 5 hips of type ?,10 hips of type?A,7 hips of type?B,3 hips of type?C and 2 hips of type?A.Big size biological cups or combine with bone graft were used in acetabular revision with prostheses.A regular follow-up was carried out after the operation.The Harris hip score and Visual Analogue Scale(VAS)score were used to evaluate the hip function and state.The prosthetic stability and bone union were judged based on the X-ray.Results: Twenty-three patients were followed up for a mean period of 39.53 months(range: 13-85 months)to evaluate the hip function and the pain problem.The condition of posterior dislocation of the femoral head has happened in 3 case at the third month after the operation when he walking on flat ground and was recovery by manual reposition.No patient required a second revision because of the failure of prosthetic revision.The screw of the prosthesis were firm and none cups was dislocated.The X-ray showed evidence of fusion between the bone graft and the host bone.The Harris hip scores were(41.18±7.59)points before the operation,(89.76±6.54)points at final follow-up after the operation(P<0.05).The VAS scores were(4.82±0.88)points before the operation,(0.39 ± 0.62)points at final follow-up after the operation(P<0.05).Conclusions: Jumbo biological cups or combine with bone graft are effective for acetabular defect in the early period after the revision operation.But the result in the long-term shloud make further observation.