Trabecular metal augments in severe malignancy-associated acetabular bone loss

Hip Int. 2023 Jul;33(4):678-684. doi: 10.1177/11207000221110787. Epub 2022 Jul 10.

Abstract

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.

Keywords: Acetabular reconstruction; orthopaedic oncology; pelvic discontinuity; pelvic malignancy; trabecular metal augment.

MeSH terms

  • Acetabulum / diagnostic imaging
  • Acetabulum / surgery
  • Arthroplasty, Replacement, Hip* / adverse effects
  • Follow-Up Studies
  • Hip Prosthesis*
  • Humans
  • Metals
  • Neoplasms* / surgery
  • Prosthesis Failure
  • Reoperation
  • Retrospective Studies

Substances

  • Metals