Acetabular reinforcement ring with hook for complex acetabular revision intotal hip arthroplasty. A minimum follow-up of 10 years

The long-term results of acetabular revision after total hip arthroplasty ( THA) with the use of a reinforcement ring with hook were evaluated. The stu dy included 57 cases of surgery dating back 10 years or more. Of a total of 54 patients (57 operated hips), 18 patients (19 hips) died during the 10-y ear period and 2 patients (2 hips) were completely lost to follow-up. At th e time of the revision surgery, the mean age of the remaining 34 patients ( 36 hips) was 62.5 years (range: 47-80). A THA revision was done in 25 cases and an acetabular revision only in 11 cases. The most common acetabular de fect was a combined segmental and cavitary defect (n = 19), and in three ca ses there was pelvic discontinuity. Autologous or homologous cancellous bon e grafts were used to fill acetabular cavities in 17 hip joints. Structured bone grafts, predominantly homologous bone,were used in ten cases for acet abular reconstruction. At a mean follow-up of 11.4 years (range: 10-14.5) three hip joints (8%) ha d undergone further revision. The revisions were done for aseptic loosening of the acetabular component in two cases and a septic loosening of both co mponents in one case. Three further cases 18%) revealed signs of acetabular loosening. Two of these three patients were symptomatic but refused furthe r revision surgery. In the 33 unrevised hip joints, a good or excellent cli nical result with a d'Aubinge score of more than 14 points was found in 30 cases (92%). Osseous acetabular reconstruction with the use of a reinforcement ring lead s to favorable results compared to other techniques. In the authors' opinio n, this technique is preferable to those using oversized cups without osseo us reconstruction of the acetabulum.