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General Orthopaedics

Acetabular Reconstruction in Severe Bone Defects Using a New Cup With Iliac Screw: Presentation and Preliminary Results

The International Society for Technology in Arthroplasty (ISTA)



Abstract

INTRODUCTION

Since July 2008 we are experimenting a new cup with iliac screw fixation, developed on the idea of Ring and Mc Minn. Iliac fixation is permitted by a polar screw of large diameter, coated by HA, which allows a compression to bone and a firm primary stability. Moreover it's possible to increase primary stability with further smaller peripherals screws. We present this new cup and report the preliminary results.

MATERIALS AND METHOD

Since July 2008 to April 2010, 51 cups were implanted. The diagnosis was aseptic loosening in 36 cases, septic loosening treated by two-stage revision in 7, hip congenital dislocation in 5, one case of post-traumatic osteoarthritis, one case of instability due to cup malposition and a case was an outcome of Girdlestone resection arthroplasty. Mean age was of 66 years (31-90).

RESULTS

We report the results of our first 23 cases, with a minimal follow-up of 12 months. Patients were preoperatively evaluated from both clinical and radiological point of view. Bone defect was analyzed according to the system of Paprosky. In 7 cases bone defect belonged to type 2C, in 8 cases to type 3A and in 8 cases to type 3B. We didn't observe any case of early loosening nor mechanical failure of the implant. The functional outcome, evaluated by Harris Hip Score, was good with a mean score of 82 (72-91).


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