Revision surgery after triple-cup arthroplasty

Although various operative procedures have been applied for advanced or ter minal osteoarthritis of the hip joints in relatively young patients, the lo ng-term results are controversial. Since 1974, we have performed the triple cup arthroplasty developed by Aoki in 110 patients who were comparatively young. The triple-cup assembly is composed of stainless-steel outer and inn er cups between which a high density polyethylene cup is incorporated, so t hat there are basically four mobile surfaces, but the major movement is act ually taking place between the outer cup and the plastic cup [8]. We have s ometimes encountered migration of the cups, which caused hip joint pain and decreased the range of motion. Revision surgery was required for 25 hip jo ints in 21 patients (23%). The acetabulum was very thin in almost all cases , so that reaming of the cavity had to be restricted to the minimum possibl e. The femoral head in the cup was often covered with a layer of fibrous ti ssue. We could utilize the femoral head as a bone graft, even though the re sidual volume of bone varied in each case. The result of revision surgeries after the triple-cup arthroplasty was good clinically and radiographically at last follow-up.