title: Tantalum augments for Paprosky IIIA defects remain stable at midterm followup.
abstract: BACKGROUND
  Initial reports with short-term followup of porous tantalum acetabular components and augments for Paprosky IIIA acetabular defects demonstrate high hip scores, low rates of aseptic loosening, and low rates of complications. However, longer-term followup with a larger cohort is needed to determine the durability of these reconstructions.
  
  
  OBJECTIVE
  We therefore determined the functional scores, rates of aseptic loosening, and complications in patients with Paprosky IIIA acetabular defects treated with porous tantalum acetabular components and augments.
  
  
  METHODS
  We retrospectively reviewed 37 acetabular revisions in 36 patients (one patient with bilateral revisions) treated with a porous tantalum acetabular component and augment. All patients had defects classified as Type IIIa using the system of Paprosky et al. Harris hip scores were obtained and radiographic examination was performed before surgery and through most recent followup. The minimum followup was 26 months (mean, 60 months; range, 26-106 months).
  
  
  RESULTS
  One patient developed aseptic loosening of the acetabular reconstruction requiring revision; seven other patients required further surgery for periprosthetic femoral fracture (two), acute infection (three), and recurrent dislocation (two). Thirty-five of 37 hips had no or occasional pain at final followup. Mean Harris hip scores improved from 33.0 preoperatively (range, 12.6-58.7) to 81.5 postoperatively (range, 27.0-99.8).
  
  
  CONCLUSIONS
  Although the complication rate requiring further surgery was considerable, most patients with these reconstructions had pain relief and reasonable function with low rates of loosening at midterm followup.
  
  
  METHODS
  Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
authors.affiliation: Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA. ddelgaizo@gmail.com
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Del Gaizo
authors.forename: Vamsi
authors.initials: V
authors.lastname: Kancherla
authors.forename: Scott M
authors.initials: SM
authors.lastname: Sporer
authors.forename: Wayne G
authors.initials: WG
authors.lastname: Paprosky
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000601:surgery*; D018771:Arthralgia / Q000209:etiology; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000295:instrumentation*; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D007087:Illinois; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology; D018579:Patient Selection; D016062:Porosity; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012086:Reoperation; D012189:Retrospective Studies; D013635:Tantalum; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D013635:Tantalum
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