A Change in the Classical Order of Setting of Porous Metal Augments with Locked Cups in Hip Revision Surgery: Technical Note and Case Report
Introduction. Reconstruction of acetabular bone defects by the combination of trabecular metal augments and porous cups can be complex when extensive bone loss and poor-quality bone exists. The onset of porous cups with an interlocking mechanism may simplify surgical technique due to its superior in...
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Wiley
2022-01-01
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| Series: | Case Reports in Orthopedics |
| Online Access: | http://dx.doi.org/10.1155/2022/4062172 |
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| author | Antonio Murcia-Asensio Francisco Ferrero-Manzanal Pablo Sanz-Ruiz Hermenegildo Cañada-Oya Raquel Lax-Pérez Christian Goetze |
| author_facet | Antonio Murcia-Asensio Francisco Ferrero-Manzanal Pablo Sanz-Ruiz Hermenegildo Cañada-Oya Raquel Lax-Pérez Christian Goetze |
| author_sort | Antonio Murcia-Asensio |
| collection | DOAJ |
| description | Introduction. Reconstruction of acetabular bone defects by the combination of trabecular metal augments and porous cups can be complex when extensive bone loss and poor-quality bone exists. The onset of porous cups with an interlocking mechanism may simplify surgical technique due to its superior initial mechanical stability. We endorse the possibility for a change in the classical order of setting of the augments and the cup. Methods. We present a technical modification and a series of cases of three patients with Paprosky IIB and IIIA acetabular defects operated with a combination of porous metal augments and a porous cup. In all the three patients, the setting of the cup was done first and secured with locked screws, and then the augments were set in place as a wedge and fixed with screws in a standard fashion. Results. The postoperative X-ray showed good position of implants with restoration of the center of rotation, and the patients had good recovery. Radiological evaluation in the midterm follow-up did not show mobilization of implants. Discussion. The use of metal porous augments is widely used for severe acetabular defects, being a versatile system to adapt to the different size defects. Nevertheless, its use may be technically demanding and time consuming. It is not infrequent that the setting of the augments conditions the final position of the cup with a possible interference with initial stability and eventually bone ingrowth of the cup. The interlocking mechanism offers an additional biomechanical stability and thus may allow us to place the cup first in the desired position with a less demanding technique. Conclusion. With the use of locked-screw porous metal cups, the order of setting of implants may be changed in order to obtain a better restoration of the center of rotation and increased host-bone implant contact with a simplified surgical technique. |
| format | Article |
| id | doaj-art-fa6c8d731da24fb49a0ced4ee852fc1f |
| institution | Kabale University |
| issn | 2090-6757 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Orthopedics |
| spelling | doaj-art-fa6c8d731da24fb49a0ced4ee852fc1f2025-02-03T05:53:29ZengWileyCase Reports in Orthopedics2090-67572022-01-01202210.1155/2022/4062172A Change in the Classical Order of Setting of Porous Metal Augments with Locked Cups in Hip Revision Surgery: Technical Note and Case ReportAntonio Murcia-Asensio0Francisco Ferrero-Manzanal1Pablo Sanz-Ruiz2Hermenegildo Cañada-Oya3Raquel Lax-Pérez4Christian Goetze5Hospital General Universitario Reina SofíaHospital General Universitario Santa LucíaHospital General Universitario Gregorio Marañón C/Doctor EsquerdoComplejo Hospitalario de Jaén Av. del Ejército EspañolHospital General Universitario Reina SofíaAuguste-Victoria-KlinikAmIntroduction. Reconstruction of acetabular bone defects by the combination of trabecular metal augments and porous cups can be complex when extensive bone loss and poor-quality bone exists. The onset of porous cups with an interlocking mechanism may simplify surgical technique due to its superior initial mechanical stability. We endorse the possibility for a change in the classical order of setting of the augments and the cup. Methods. We present a technical modification and a series of cases of three patients with Paprosky IIB and IIIA acetabular defects operated with a combination of porous metal augments and a porous cup. In all the three patients, the setting of the cup was done first and secured with locked screws, and then the augments were set in place as a wedge and fixed with screws in a standard fashion. Results. The postoperative X-ray showed good position of implants with restoration of the center of rotation, and the patients had good recovery. Radiological evaluation in the midterm follow-up did not show mobilization of implants. Discussion. The use of metal porous augments is widely used for severe acetabular defects, being a versatile system to adapt to the different size defects. Nevertheless, its use may be technically demanding and time consuming. It is not infrequent that the setting of the augments conditions the final position of the cup with a possible interference with initial stability and eventually bone ingrowth of the cup. The interlocking mechanism offers an additional biomechanical stability and thus may allow us to place the cup first in the desired position with a less demanding technique. Conclusion. With the use of locked-screw porous metal cups, the order of setting of implants may be changed in order to obtain a better restoration of the center of rotation and increased host-bone implant contact with a simplified surgical technique.http://dx.doi.org/10.1155/2022/4062172 |
| spellingShingle | Antonio Murcia-Asensio Francisco Ferrero-Manzanal Pablo Sanz-Ruiz Hermenegildo Cañada-Oya Raquel Lax-Pérez Christian Goetze A Change in the Classical Order of Setting of Porous Metal Augments with Locked Cups in Hip Revision Surgery: Technical Note and Case Report Case Reports in Orthopedics |
| title | A Change in the Classical Order of Setting of Porous Metal Augments with Locked Cups in Hip Revision Surgery: Technical Note and Case Report |
| title_full | A Change in the Classical Order of Setting of Porous Metal Augments with Locked Cups in Hip Revision Surgery: Technical Note and Case Report |
| title_fullStr | A Change in the Classical Order of Setting of Porous Metal Augments with Locked Cups in Hip Revision Surgery: Technical Note and Case Report |
| title_full_unstemmed | A Change in the Classical Order of Setting of Porous Metal Augments with Locked Cups in Hip Revision Surgery: Technical Note and Case Report |
| title_short | A Change in the Classical Order of Setting of Porous Metal Augments with Locked Cups in Hip Revision Surgery: Technical Note and Case Report |
| title_sort | change in the classical order of setting of porous metal augments with locked cups in hip revision surgery technical note and case report |
| url | http://dx.doi.org/10.1155/2022/4062172 |
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