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Risk factors for implant failure of custom-made acetabular implants in patients with Paprosky III acetabular bone loss and combined pelvic discontinuity

BACKGROUND: Severe acetabular bone loss in revision total hip arthroplasty (RTHA), both with or without pelvic discontinuity, remains a great challenge in orthopaedic surgery. OBJECTIVE: The aim of this study was to evaluate risk factors for failure of custom-made acetabular implants in RTHA. METHOD...

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Main Authors: Fröschen, Frank Sebastian (Author) , Randau, Thomas M. (Author) , Gravius, Nadine (Author) , Wirtz, Dieter C. (Author) , Gravius, Sascha (Author) , Walter, Sebastian G. (Author)
Format: Article (Journal)
Language:English
Published: 12 May 2022
In: Technology and health care
Year: 2022, Volume: 30, Issue: 3, Pages: 703-711
ISSN:1878-7401
DOI:10.3233/THC-202236
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.3233/THC-202236
Verlag, lizenzpflichtig, Volltext: https://content.iospress.com/articles/technology-and-health-care/thc202236?resultNumber=0&totalResults=14&start=0&q=Risk+factors+for+implant+failure+of+custom-made+acetabular+implants+in+patients+with+Paprosky+III+acetabular+bone+loss+and+combined+pelvic+discontinuity+&resultsPageSize=10&rows=10
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Author Notes:Frank S. Fröschen, Thomas M. Randau, Nadine Gravius, Dieter C. Wirtz, Sascha Gravius and Sebastian G. Walter
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Summary:BACKGROUND: Severe acetabular bone loss in revision total hip arthroplasty (RTHA), both with or without pelvic discontinuity, remains a great challenge in orthopaedic surgery. OBJECTIVE: The aim of this study was to evaluate risk factors for failure of custom-made acetabular implants in RTHA. METHODS: Seventy patients with severe acetabular bone loss (Paprosky Type III) and pelvic discontinuity, who required RTHA, were included in our study. All prostheses were constructed based on a thin-layer computed-tomography (CT) scan of the pelvis. The treatment was considered unsuccessful in the event of periprosthetic joint infection (PJI) or aseptic loosening (AL) with need for explantation of the custom-made acetabular implant. RESULTS: The average follow-up was 41.9 ± 34.8 months (range 1.5–120). Implant survival at last follow-up was 75.7% (53 of 70). Explantation was necessary in 17 cases (15 PJI; 2 AL). Previous PJI as reason for RTHA (p= 0.025; OR 3.56 (95% CI: 1.14; 11.21)), additional revision of femoral components (p= 0.003; OR 8.4 (95% CI: 1.75; 40.42)), rheumatoid disease (p= 0.039; OR 3.43 (95% CI: 1.01; 11.40)), elevated preoperative CRP > 15.2 mg/l (p= 0.015; AUC: 0.7) and preoperative haemoglobin < 10.05 (p= 0.022; AUC: 0.69) were statistically significant risk factors associated with treatment failure. Age and BMI were not statistically significant contributing to implant failure. CONCLUSION: Risk factors for treatment failure were a previous PJI, additional revision of femoral component, rheumatoid disease, elevated preoperative CRP and low preoperative haemoglobin. Awareness of these risk factors will help to improve future treatment standards.
Item Description:Gesehen am 24.06.2024
Physical Description:Online Resource
ISSN:1878-7401
DOI:10.3233/THC-202236

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