title: High complication rate in reconstruction of Paprosky type IIIa acetabular defects using an oblong implant with modular side plates and a hook.
abstract: We report the results of 62 hips in 62 patients (17 males, 45 females) with mean age of 62.4 years (37 to 81), who underwent revision of the acetabular component of a total hip replacement due to aseptic loosening between May 2003 and November 2007. All hips had a Paprosky type IIIa acetabular defect. Acetabular revision was undertaken using a Procotyl E cementless oblong implant with modular side plates and a hook combined with impaction allografting.  At a mean follow-up of 60.5 months (36 to 94) with no patients lost to follow-up and one died due to unrelated illness, the complication rate was 38.7%. Complications included aseptic loosening (19 hips), deep infection (3 hips), broken hook and side plate (one hip) and a femoral nerve palsy (one hip). Further revision of the acetabular component was required in 18 hips (29.0%) and a further four hips (6.4%) are currently loose and awaiting revision.  We observed unacceptably high rates of complication and failure in our group of patients and cannot recommend this implant or technique.
authors.affiliation: General University Hospital ATTIKON, Athens University Medical School, 1st Orthopaedic Department, 1 Rimini Street, 12462 Haidari, Greece. george.babis@gmail.com
authors.forename: G C
authors.initials: GC
authors.lastname: Babis
authors.forename: V I
authors.initials: VI
authors.lastname: Sakellariou
authors.forename: A N
authors.initials: AN
authors.lastname: Chatziantoniou
authors.forename: P N
authors.initials: PN
authors.lastname: Soucacos
authors.forename: P
authors.initials: P
authors.lastname: Megas
mesh_terms: D000077:Acetabulum / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D016268:Internal Fixators / Q000592:standards; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D012086:Reoperation / Q000706:statistics & numerical data; D017211:Treatment Failure