title: Acetabular revision arthroplasty: using the Hastings bipolar head to enable retention of a well-fixed monoblock stem.
abstract: We describe a novel technique of combining the Hastings bipolar head, matched in size to the acetabular cup liner, with a fixed, cemented monoblock stem allowing for isolated uncemented acetabular revision arthroplasty.
  
  
  OBJECTIVE
  To assess patient clinical and radiological outcomes after isolated uncemented acetabular revision arthroplasty using the Hastings bipolar head.
  
  
  METHODS
  Clinical outcome was assessed with the Oxford and WOMAC hip scores. Radiographs were assessed preoperatively for acetabular defects. Post operative osseointegration of the acetabular cup was then classified and the femoral stem was examined for signs of loosening.
  
  
  RESULTS
  Nine acetabular components were revised in eight patients. Preoperative acetabular defects ranged from Paprosky type 1 to 3A. There were no significant intra or postoperative complications. At a mean final follow-up of 15 months, the Oxford hip score improved from an average of 17.5 preoperatively to 44.1, and the WOMAC score had improved from 44.1 to 90.9. Eight acetabular cups demonstrated three or more signs of osseointegration with the remaining cup showing two signs. There were no signs of loosening of the retained femoral stems.
  
  
  CONCLUSIONS
  These short term results of the use of the Hastings bipolar head in isolated uncemented acetabular revision arthroplasty demonstrate good patient outcomes, reduced morbidity, decreased technical difficulties for the surgeon and reduced expense for the health service.
authors.affiliation: Department of Trauma and Orthopaedics, Galway University Hospital, Galway, Ireland. louisemcloughlin2@gmail.com
authors.forename: Louise
authors.initials: L
authors.lastname: McLoughlin
authors.forename: Michael
authors.initials: M
authors.lastname: Leonard
authors.forename: William
authors.initials: W
authors.lastname: Curtin
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D005260:Female; D005270:Femur Head / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome