Indications and limits of acetabular reimplantations using screwed prostheses.
The clinical and radiographic results of 95 acetabular reimplantations performed between 1984 and 1992 are presented. A screwed acetabular prosthesis was used in 56 patients, the acetabulum was cemented in 15, and a press-fit acetabulum stabilized by screws (1 case without screws) was used in 24. Mean clinical follow-up was 35.6 +/- 24 months, ranging from 7 to 94 months. Clinical results were good and excellent (> or = 5 points according to Merle D'Aubigné) in 77% of the cases for pain, in 70% for walking, and in 71% for joint movement. Forty months after surgery 48% of the screwed acetabula and 44% of the cemented ones were osteointegrated. The incidence of loosening for the screwed acetabula was 24%. The preliminary results 24 months after the press-fit acetabula with screws had been inserted showed 100% osteointegration. Radiographic results of the screwed acetabula were satisfactory (92% osteointegration) only in reimplantations performed in patients with minimum acetabular osteolytic injury (Paprosky types I and IIA). The use of homoplastic bone grafts did not improve the radiographic results of the screwed acetabula in the cases with severe osteolysis: 57% of the acetabula screwed on grafts distributed throughout the acetabulum were, in fact, loosened.
Toni
A
A
Clinica Ortopedica, Istituto Ortopedico Rizzoli, Bologna.
Sudanese
A
A
Bueno Lozano
A L
AL
Calista
F
F
Fabbri
F
F
Scimeca
G B
GB
Masetti
G
G
Giunti
A
A
D000077:Acetabulum / Q000000981:diagnostic imaging / Q000601:surgery*; D001843:Bone Cements; D001862:Bone Resorption / Q000601:surgery; D001863:Bone Screws; D016025:Bone Transplantation; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000295:instrumentation*; D006801:Humans; D016348:Osseointegration; D011474:Prosthesis Design; D011859:Radiography; D012086:Reoperation
D001843:Bone Cements