Porous Tantalum Buttress Augments for Severe Acetabular Posterior Column Deficiency

R. Meneghini, Jason R. Hull, Glenn S. Russo, Jay R. Lieberman, William A. Jiranek

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

In revision total hip arthroplasty (THA), consensus is lacking regarding the optimal method for reconstruction of the most severe acetabular defects. Porous tantalum (TM) buttress augments were designed for the most severe postero-superior defects. The purpose of this study was to report the results of a consecutive series of acetabular reconstructions utilizing TM buttress augments. Eight complex acetabular reconstructions utilizing a TM buttress augment were performed at two centers. All were Paprosky 3A or Paprosky 3B bone loss classification, with severe superior and posterior column deficiency where wedge augments were insufficient for mechanical support. The acetabular cup sizes ranged from 64-78, and a buttress shim was used in 7 of 8 cases. Clinical and radiographic follow-up averaged 16.5 months (range, 10-28) and no cases were lost to follow-up. There were no cases of clinical or radiographic loosening, and no case had required reoperation or revision. All patients except one were ambulating with either no assist device or a single cane at final follow-up. There was one complication of an iliac wing fracture noted incidentally on postoperative x-rays in the lone patient in whom a buttress shim was not used. At short-term follow-up, TM acetabular buttress augments appear to effectively substitute for the use of structural allografts or cages, which would otherwise be used in this challenging setting. The potential for biologic fixation is promising for the durability of these reconstructions; however, longer-term follow-up is required for full evaluation.

Original languageEnglish (US)
Pages (from-to)240-244
Number of pages5
JournalSurgical technology international
Volume27
StatePublished - Nov 1 2015
Externally publishedYes

Fingerprint

Tantalum
Canes
Lost to Follow-Up
Reoperation
Arthroplasty
Allografts
Hip
X-Rays
Bone and Bones
Equipment and Supplies

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Meneghini, R., Hull, J. R., Russo, G. S., Lieberman, J. R., & Jiranek, W. A. (2015). Porous Tantalum Buttress Augments for Severe Acetabular Posterior Column Deficiency. Surgical technology international, 27, 240-244.

Porous Tantalum Buttress Augments for Severe Acetabular Posterior Column Deficiency. / Meneghini, R.; Hull, Jason R.; Russo, Glenn S.; Lieberman, Jay R.; Jiranek, William A.

In: Surgical technology international, Vol. 27, 01.11.2015, p. 240-244.

Research output: Contribution to journalArticle

Meneghini, R. ; Hull, Jason R. ; Russo, Glenn S. ; Lieberman, Jay R. ; Jiranek, William A. / Porous Tantalum Buttress Augments for Severe Acetabular Posterior Column Deficiency. In: Surgical technology international. 2015 ; Vol. 27. pp. 240-244.
@article{6a3428d6c802459db17d7533075a777b,
title = "Porous Tantalum Buttress Augments for Severe Acetabular Posterior Column Deficiency",
abstract = "In revision total hip arthroplasty (THA), consensus is lacking regarding the optimal method for reconstruction of the most severe acetabular defects. Porous tantalum (TM) buttress augments were designed for the most severe postero-superior defects. The purpose of this study was to report the results of a consecutive series of acetabular reconstructions utilizing TM buttress augments. Eight complex acetabular reconstructions utilizing a TM buttress augment were performed at two centers. All were Paprosky 3A or Paprosky 3B bone loss classification, with severe superior and posterior column deficiency where wedge augments were insufficient for mechanical support. The acetabular cup sizes ranged from 64-78, and a buttress shim was used in 7 of 8 cases. Clinical and radiographic follow-up averaged 16.5 months (range, 10-28) and no cases were lost to follow-up. There were no cases of clinical or radiographic loosening, and no case had required reoperation or revision. All patients except one were ambulating with either no assist device or a single cane at final follow-up. There was one complication of an iliac wing fracture noted incidentally on postoperative x-rays in the lone patient in whom a buttress shim was not used. At short-term follow-up, TM acetabular buttress augments appear to effectively substitute for the use of structural allografts or cages, which would otherwise be used in this challenging setting. The potential for biologic fixation is promising for the durability of these reconstructions; however, longer-term follow-up is required for full evaluation.",
author = "R. Meneghini and Hull, {Jason R.} and Russo, {Glenn S.} and Lieberman, {Jay R.} and Jiranek, {William A.}",
year = "2015",
month = "11",
day = "1",
language = "English (US)",
volume = "27",
pages = "240--244",
journal = "Surgical technology international",
issn = "1090-3941",
publisher = "Universal Medical Press",

}

TY - JOUR

T1 - Porous Tantalum Buttress Augments for Severe Acetabular Posterior Column Deficiency

AU - Meneghini, R.

AU - Hull, Jason R.

AU - Russo, Glenn S.

AU - Lieberman, Jay R.

AU - Jiranek, William A.

PY - 2015/11/1

Y1 - 2015/11/1

N2 - In revision total hip arthroplasty (THA), consensus is lacking regarding the optimal method for reconstruction of the most severe acetabular defects. Porous tantalum (TM) buttress augments were designed for the most severe postero-superior defects. The purpose of this study was to report the results of a consecutive series of acetabular reconstructions utilizing TM buttress augments. Eight complex acetabular reconstructions utilizing a TM buttress augment were performed at two centers. All were Paprosky 3A or Paprosky 3B bone loss classification, with severe superior and posterior column deficiency where wedge augments were insufficient for mechanical support. The acetabular cup sizes ranged from 64-78, and a buttress shim was used in 7 of 8 cases. Clinical and radiographic follow-up averaged 16.5 months (range, 10-28) and no cases were lost to follow-up. There were no cases of clinical or radiographic loosening, and no case had required reoperation or revision. All patients except one were ambulating with either no assist device or a single cane at final follow-up. There was one complication of an iliac wing fracture noted incidentally on postoperative x-rays in the lone patient in whom a buttress shim was not used. At short-term follow-up, TM acetabular buttress augments appear to effectively substitute for the use of structural allografts or cages, which would otherwise be used in this challenging setting. The potential for biologic fixation is promising for the durability of these reconstructions; however, longer-term follow-up is required for full evaluation.

AB - In revision total hip arthroplasty (THA), consensus is lacking regarding the optimal method for reconstruction of the most severe acetabular defects. Porous tantalum (TM) buttress augments were designed for the most severe postero-superior defects. The purpose of this study was to report the results of a consecutive series of acetabular reconstructions utilizing TM buttress augments. Eight complex acetabular reconstructions utilizing a TM buttress augment were performed at two centers. All were Paprosky 3A or Paprosky 3B bone loss classification, with severe superior and posterior column deficiency where wedge augments were insufficient for mechanical support. The acetabular cup sizes ranged from 64-78, and a buttress shim was used in 7 of 8 cases. Clinical and radiographic follow-up averaged 16.5 months (range, 10-28) and no cases were lost to follow-up. There were no cases of clinical or radiographic loosening, and no case had required reoperation or revision. All patients except one were ambulating with either no assist device or a single cane at final follow-up. There was one complication of an iliac wing fracture noted incidentally on postoperative x-rays in the lone patient in whom a buttress shim was not used. At short-term follow-up, TM acetabular buttress augments appear to effectively substitute for the use of structural allografts or cages, which would otherwise be used in this challenging setting. The potential for biologic fixation is promising for the durability of these reconstructions; however, longer-term follow-up is required for full evaluation.

UR - http://www.scopus.com/inward/record.url?scp=84975914384&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84975914384&partnerID=8YFLogxK

M3 - Article

C2 - 26680404

AN - SCOPUS:84975914384

VL - 27

SP - 240

EP - 244

JO - Surgical technology international

JF - Surgical technology international

SN - 1090-3941

ER -