Cementless acetabular revision arthroplasty

OBJECTIVE: To evaluate the effects of clinical factors on outcome after ace tabular revision with a cementless beaded cup. DESIGN: Retrospective case series. SETTING: Tertiary care referral centre. PATIENTS: Forty-one patients who underwent acetabular revision with a cemen tless cup were followed up for a mean of 3.4 years. INTERVENTIONS: Acetabular revision with a beaded cementless cup in all pati ents. A morcellized allograft was used in 10 patients. OUTCOME MEASURES: A modified Harris hip score (range of motion measurement omitted), the SF-36 health survey, and the Western Ontario McMaster (WOMAC) osteoarthritis index. Multivariate analysis was used to evaluate the effec ts of age, gender, morcellized allografting, time to revision from the prev ious operation, acetabular screw fixation and concurrent femoral revision o n outcome. RESULTS: Gender accounted for a significant portion of thr variation seen i n the SF-36 physical component scores (r = 0.36, p = 0.02), with women tend ing to have worse results. Increasing age was associated with lower WOMAC i ndex function scores (r = 0.36, p = 0.03), whereas concurrent femoral revis ion tended to have a positive effect on WOMAC index function (r = 0.39, p = 0.01). None of the potential clinical predictors had any significant effec t on thr SF-36 mental component scores, or WOMAC index pain and stiffness s cores. CONCLUSIONS: In cementless acetabular revision arthroplasty, physical funct ion, as measured by generic and limb-specific scales, may be affected by ge nder, age and the presence of a concurrent femoral revision. Time to revisi on from the previous operation, morcellized allografting and screw fixation of the acetabulum did not affect outcomes. This information may provide so me prognostic value for patients' expectations.