Analysis Of Early Efficacy Of Titanium Metal Augments In The Treatment Of Acetabular Bone Defect

Objective:To evaluate the effect of Titanium metal augments in the treatment of acetabular bone defect in primary total hip arthroplasty and revision total hip arthroplasty.Methods:A retrospective analysis of 30 patients(30 hips)who underwent total hip arthroplasty or revision total hip arthroplasty in the Department of Orthopaedics,the First Affiliated Hospital of Shandong First Medical University from January 2017 to October 2022.There were 21 patients(21 hips)with prosthesis loosening after hip revision,including 19 patients(19 hips)with aseptic loosening and 2 patients(2 hips)with infection,4 patients(4 hips)with Developmental Dysplasia of the Hip,Osteonecrosis of femoral head in 3 patients(3 hips),1 cases(1 hips)of severe rheumatoid arthritis and 1 cases(1 hips)of osteoarthritis.According to the postoperative and preoperative X-ray changes,evaluating the type of bone defect and recording the location of bone defect and the changes of the position of the rotation center of the hip joint,the changes of the position of the rotation center of the hip joint,the translucent line around the augment and cup,the gap between the prosthesis and bone and the state of the screw were compared.The general condition and postoperative complications of the patients,Harris hip score score and Visual Analogue Scale of preoperative and postoperative follow-up were collected.Paired T-test was used to compare the changes of functional score and hip rotation center before and after operation.Results:A total of 30 patients were followed up,none of them lost follow-up.All types were classified by Paprosky classification,including 1 case(1 hip)of Paprosky type ⅡA,5 cases(5 hips)of type ⅡB,1 case(1 hip)of type ⅡC,13 cases(13 hips)of type ⅢA and 10 cases(10 hips)of type ⅢB.Taking the need for further revision as a failure,the overall success rate of the operation in this study was 100%.All cups and augments were well fixed and there was no implant failure at the end of this study.One patient underwent necrosectomy because of hip infection,and the prosthesis was not removed.The infection was controlled after anti-infective treatment.The average follow-up time was 27.83(±9.38)months,the longest was 64 months and the shortest was 10 months.The average Harris score increased from 59.6(± 5.68)before operation to 87.54(±7.2)after surgery,and the average VAS score decreased from 6.6(±1.91)before operation to 1.8(± 0.80)after surgery,the difference had statistic significance(P<0.05).After operation,the rotation center moved down by an average of 23.54(±12.15)mm,the difference had statistic significance(P<0.05),and there was no significant difference in the distance of internal movement.The position of the rotation center was close to the position of the contralateral normal hip joint after operation.The acetabular cups and metal augments had no obvious displacement,the acetabular cup and metal augment were well osseointegrated with bone,there was no obvious radiolucent line and loosening,there was no screw fracture,and the bone defect was ideally filled.Conclusion:Titanium augments showed a good early effect in the repair of acetabular bone defect,and the postoperative follow-up showed good stability and no obvious loosening.Titanium augments can effectively restore the rotation center of the femoral head and significantly improve the function of the hip joint of patients.