Trabecular Metal™ Cups for Acetabular Defects With 50% or Less Host Bone Contact

Dror Lakstein MD, David Backstein MD, MEd, FRCSC, Oleg Safir MD, FRCSC, Yona Kosashvili MD, MHA, Allan E. Gross MD, FRCSC
Symposium: Papers Presented at the Annual Closed Meeting of the International Hip Society
Volume 467, Issue 9 / September , 2009

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Abstract

Acetabular component revision in the context of large contained bone defects with less than 50% host bone contact traditionally have been treated with roof reinforcement or antiprotrusio cages. Trabecular Metal™ cups (Zimmer, Inc, Warsaw, IN) may offer a reasonable treatment alternative. We evaluated the clinical and radiographic outcome of this mode of treatment. We prospectively followed 53 hip revision acetabular arthroplasty procedures performed with Trabecular Metal™ cups for contained defects with 50% or less contact with native bone. All patients were clinically and radiographically evaluated for evidence of loosening or failure. Minimum followup was 24 months (average, 45 months; range, 24–71 months). Contact with host bone ranged from 0% to 50% (average, 19%). The mean postoperative Merle d’Aubigne-Postel score was 10.6 (range, 1–12), with a mean improvement of 5.2 (range, −4–10) compared to the preoperative score. Two failed cups (4%) were revised. Two additional cups (4%) had radiographic evidence of probable loosening. Complications included four dislocations and one sciatic nerve palsy. The data suggest treatment of cavitary defects with less than 50% host bone contact using Trabecular Metal™ cups, without structural support by augments or structural bone grafts, is a reasonable option.

Level of Evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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