title: Tantalum acetabular cups provide secure fixation in THA after pelvic irradiation at minimum 5-year followup.
abstract: BACKGROUND
  Pelvic radiation has been commonly used to treat gastrointestinal, genitourinary, or hematopoietic malignancies. Conventional THA in these patients reportedly have high rates of fixation failure. Although secure short-term fixation reportedly occurs with trabecular metal implants following pelvic radiation, it is unclear whether the fixation is durable.
  
  
  OBJECTIVE
  We determined the survival of trabecular metal acetabular components in patients having THA following pelvic radiation and assessed function and radiographic loosening.
  
  
  METHODS
  We retrospectively reviewed 29 patients with prior pelvic radiation who had 34 arthroplasties using trabecular metal acetabular components from 1998 and 2005. The mean pelvic radiation dose was 6300 cGy. We collected the following data: patient demographics, surgery and implant information, clinical and radiographic followup, and tumor and radiotherapy related details. We obtained Harris hip scores (HHS) on all patients. Ten patients died of disease prior to 5 years and two patients were excluded, leaving 17 patients (22 hips) with a minimum of 5 years of clinical (mean, 78 months; median, 71; range, 57-116) and radiographic (mean, 73; median, 65; range, 51-116) followup.
  
  
  RESULTS
  All implants were in place in the surviving patients. The mean HHS improved from 36 preoperatively to 80 at latest followup. There were no reoperations for any reason, and we observed no implant loosening or migration at final followup in surviving or deceased patients.
  
  
  CONCLUSIONS
  Tantalum trabecular metal acetabular components restored function and provided durable reconstruction in patients undergoing THA following prior pelvic radiation. We observed no clinical or radiographic failures at a minimum 5-year followup.
  
  
  METHODS
  Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
authors.affiliation: Department of Orthopedics, Mayo Clinic, 14th Floor, Gonda Building, 200 1st Street SW, Rochester, MN 55902, USA.
authors.forename: Siddharth B
authors.initials: SB
authors.lastname: Joglekar
authors.forename: Peter S
authors.initials: PS
authors.lastname: Rose
authors.forename: David G
authors.initials: DG
authors.lastname: Lewallen
authors.forename: Franklin H
authors.initials: FH
authors.lastname: Sim
mesh_terms: D000077:Acetabulum / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D001672:Biocompatible Materials; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint; D006622:Hip Prosthesis; D006801:Humans; D007592:Joint Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010384:Pelvic Bones / Q000528:radiation effects*; D011475:Prosthesis Failure; D011878:Radiotherapy / Q000009:adverse effects; D012189:Retrospective Studies; D013635:Tantalum
chemical_list: D001672:Biocompatible Materials; D013635:Tantalum