title: Revision total hip replacement using the cement-in-cement technique for the acetabular component: technique and results for 60 hips.
abstract: The technique of femoral cement-in-cement revision   is well established, but there are no previous series reporting its   use on the acetabular side at the time of revision total hip replacement.   We describe the technique and report the outcome of 60 consecutive   acetabular cement-in-cement revisions in 59 patients at a mean follow-up   of 8.5 years (5 to 12). All had a radiologically and clinically   well-fixed acetabular cement mantle at the time of revision. During   the follow-up 29 patients died, but no hips were lost to follow-up.   The two most common indications for acetabular revision were recurrent   dislocation (46, 77%) and to complement femoral revision (12, 20%).  Of the 60 hips, there were two cases of aseptic loosening of   the acetabular component (3.3%) requiring re-revision. No other   hip was clinically or radiologically loose (96.7%) at the latest   follow-up. One hip was re-revised for infection, four for recurrent   dislocation and one for disarticulation of a constrained component.   At five years the Kaplan-Meier survival rate was 100% for aseptic   loosening and 92.2% (95% CI 84.8 to 99.6), with revision for any cause   as the endpoint. These results support the use of cement-in-cement revision on   the acetabular side in appropriate cases. Theoretical advantages   include preservation of bone stock, reduced operating time, reduced   risk of complications and durable fixation.
authors.affiliation: Princess Elizabeth Orthopaedic Centre, Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter EX2 5DW, UK.
authors.forename: K
authors.initials: K
authors.lastname: Brogan
authors.forename: J
authors.initials: J
authors.lastname: Charity
authors.forename: A
authors.initials: A
authors.lastname: Sheeraz
authors.forename: S L
authors.initials: SL
authors.lastname: Whitehouse
authors.forename: A J
authors.initials: AJ
authors.lastname: Timperley
authors.forename: J R
authors.initials: JR
authors.lastname: Howell
authors.forename: M J W
authors.initials: MJ
authors.lastname: Hubble
mesh_terms: D000077:Acetabulum / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D001843:Bone Cements / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D001843:Bone Cements