title: A cemented acetabular component with a reinforcement cross provides excellent medium-term fixation in total hip arthroplasty after pelvic irradiation.
abstract: Conventional cemented acetabular components are reported to have a high rate of failure when implanted into previously irradiated bone. We recommend the use of a cemented reconstruction with the addition of an acetabular reinforcement cross to improve fixation. We reviewed a cohort of 45 patients (49 hips) who had undergone irradiation of the pelvis and a cemented total hip arthroplasty (THA) with an acetabular reinforcement cross. All hips had received a minimum dose of 30 Gray (Gy) to treat a primary nearby tumour or metastasis. The median dose of radiation was 50 Gy (Q1 to Q3: 45 to 60; mean: 49.57, 32 to 72). The mean follow-up after THA was 51 months (17 to 137). The cumulative probability of revision of the acetabular component for a mechanical reason was 0% (0 to 0%) at 24 months, 2.9% (0.2 to 13.3%) at 60 months and 2.9% (0.2% to 13.3%) at 120 months, respectively. One hip was revised for mechanical failure and three for infection. Cemented acetabular components with a reinforcement cross provide good medium-term fixation after pelvic irradiation. These patients are at a higher risk of developing infection of their THA.
authors: Hôpital Cochin, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France.
authors: A
authors: A
authors: Felden
authors: Pavillon T de l'Hôpital Edouard Herriot, Hospices Civils de Lyon, place d'Arsonval, 69003 Lyon, France.
authors: G
authors: G
authors: Vaz
authors: Hôpital Européen Georges Pompidou, 20 Rue Leblanc, 75015 Paris, France.
authors: S
authors: S
authors: Kreps
authors: Hôpital Cochin, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France.
authors: P
authors: P
authors: Anract
authors: Hôpital Cochin, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France.
authors: M
authors: M
authors: Hamadouche
authors: Hôpital Cochin, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France.
authors: D J
authors: DJ
authors: Biau
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods; D001859:Bone Neoplasms / Q000532:radiotherapy; D002484:Cementation; D005260:Female; D005266:Femoral Neoplasms / Q000601:surgery; D005271:Femur Head Necrosis / Q000601:surgery; D005598:Fractures, Spontaneous / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010000:Osteitis / Q000601:surgery; D010384:Pelvic Bones / Q000528:radiation effects*; D011474:Prosthesis Design; D012189:Retrospective Studies; D014516:Ureteral Neoplasms / Q000532:radiotherapy; D001749:Urinary Bladder Neoplasms / Q000601:surgery; D014565:Urogenital Neoplasms / Q000601:surgery*
keywords: Acetabular reinforcement; Cemented; Hip; Pelvic irradiation; Radiation osteitis; Replacement