Revision Total Hip Arthroplasty: Acetabular Cup / 대한고관절학회지

ABSTRACT

Recently, the incidence of revision total hip arthroplasty following primary total hip arthroplasty has increased. However, revision after primary total hip arthroplasty is usually much more difficult than the first time, and the results are typically not as satisfactory as that after most primary total hip arthroplasty procedures. Therefore, thoughtful and thorough preoperative planning will certainly provides the patient with the best opportunity for long-term success. In particular, location and size of acetabular bone defects dictate the type of acetabular component in revision in total hip arthroplasty. For most defects, a porous-coated hemispherical shell secured to host bone with multiple screws is the implant of choice. This reconstruction is feasible provided that at least 50% of the implant is in contact with host bone. When such contact is not possible, and there is adequate medial and peripheral bone, techniques using alternative uncemented implants can be used for acetabular reconstruction. Defects with greater bone loss or compromised columns require the use of either modular augments combined with a hemispherical shell, reconstruction cages, structural allografts, or impaction allograft. Therefore, we attempt to introduce the most commonly-adopted system for classification of acetabular defects and the necessary preoperative evaluation, intraoperative detail, and reported results of these acetabular revisions.