Rebuilding the skeleton: the intraoperative use of trabecular metal in revision total hip arthroplasty.
Cages provide a scaffold for restoration of bone stock in revision arthroplasty of the acetabulum. A major problem with cages is failure at 5 to 10 years due to loss of fixation. The present generation of cages are not made of a material that provides biologic fixation. Trabecular metal cups provide excellent biologic fixation and a favorable environment for bone graft remodeling. For large bone defects where there is not optimal contact with host bone at the correct anatomic level, a trabecular cup is placed against bone graft, fixed with screws, and protected by a cage into which the polyethylene cup is cemented. The initial stability is via the cage, but when graft remodeling takes place, the stress will be taken by the trabecular metal relieving the stress on the cage.
Faculty of Medicine, University of Toronto, Division of Orthopaedic Surgery, Mount Sinai Hospital, 600 University Avenue, Toronto, Ontario, Canada M5G 1X5.
Allan E
AE
Gross
Stuart B
SB
Goodman
D000077:Acetabulum / Q000601:surgery*; D019644:Arthroplasty, Replacement, Hip / Q000379:methods; D016025:Bone Transplantation; D006801:Humans; D007432:Intraoperative Period; D008670:Metals; D011475:Prosthesis Failure; D012086:Reoperation / Q000295:instrumentation*
D008670:Metals