Tantalum components in difficult acetabular revisions.
Although porous-coated hemispherical components are usually successful in acetabular revisions, the rate of failure is increased in hips with severe bone loss. Tantalum acetabular implants are characterized by higher friction, higher porosity, and greater osteoconductivity than titanium mesh or chrome-cobalt beads. We asked whether these components would provide stable short-term fixation without radiographic loosening in revisions at higher risk for failure. We prospectively followed 37 patients (39 hips) who had an acetabular revision with tantalum acetabular components. The minimum followup time was 2 years (mean, 3.3 years; range, 2-7 years). The acetabular defects were classified as Paprosky et al. Type 3 in 26, Type 2 in 11, and Type 1 in two hips. The mean postoperative Harris hip score was 86. Thirty-eight of the 39 (97%) tantalum components were radiographically well fixed. There was one mechanical failure at 6 months, rerevised with a larger tantalum component. Bone ingrowth was apparent in 38 hips and four hips had a radiolucent line. There were six other reoperations, three recurrent dislocations (constrained liners leaving the shell in place), two infections that seeded to the hip from elsewhere and treated with drainage, and one supracondylar femur fracture, but the tantalum component was left in place. Tantalum acetabular components provide stable fixation in difficult acetabular revisions.


METHODS
Level IV, case series. See Guidelines for Authors for a complete description of levels of evidence.
Lachiewicz
Paul F
PF
Chapel Hill Orthopedics Surgery and Sports Medicine, 101 Conner Drive, Suite 200, Chapel Hill, NC 27514, USA. paul_lachiewicz@hotmail.com
Soileau
Elizabeth S
ES
D000077:Acetabulum / Q000000981:diagnostic imaging / Q000601:surgery*; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000295:instrumentation*; D020099:Coated Materials, Biocompatible; D005260:Female; D017276:Friction; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D004204:Joint Dislocations / Q000209:etiology / Q000517:prevention & control; D007593:Joint Instability / Q000209:etiology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D010147:Pain Measurement; D016062:Porosity; D011446:Prospective Studies; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D020127:Recovery of Function; D012086:Reoperation; D013314:Stress, Mechanical; D013499:Surface Properties; D013635:Tantalum; D013997:Time Factors; D016896:Treatment Outcome
D020099:Coated Materials, Biocompatible; D013635:Tantalum