0 Item(s)
Acetabular Revision With Triflange Cups
Custom triflange acetabular cups are indicated for the presence of massive acetabular bone loss (Paprosky type IIIB [columns intact, superior lateral migration creating a dome defect, migration of the femoral head
center less than 3 cm, minimal ischial lysis, Köhler line intact] in revision total hip arthroplasty. A paucity of evidence is available for review because of the rare need to use these custom implants. Short-term and midterm results have been promising, with reported clinical success rates between 79% and 100%. In addition, radiographic healing of pelvic discontinuities has been reported in 81% to 97% of patients. Mechanical failures have been observed in only a small percentage of patients and appear to be associated with pelvic discontinuities without supplemental posterior column plate or locking screw fixation. The most commonly reported reason for revision surgery is recurrent instability requiring conversion to a constrained liner. This chapter reviews the indications, contraindications, results, and surgical techniques related to the use of custom triflange acetabular cups in revision total hip arthroplasty. Postoperative protocols and tips for successful surgery are also presented.