The use of cementless acetabular component in revision surgery without pelvic discontinuity.

ABSTRACT

Reconstruction of the failed acetabular component in total hip arthroplasty (THA) can be challenging. Although there are multiple reconstructive options available, a cementless acetabular component inserted with screws has been shown to have good intermediate-term results and is the reconstructive method of choice for the majority of acetabular revisions This reconstruction is feasible provided at least 50% of the implant contacts host bone. When such contact is not possible, and there is adequate medial and peripheral bone, techniques using alternative uncemented implants can be used for acetabular reconstruction. An uncemented cup can be placed at a "high hip center." Alternatively, the acetabular cavity can be progressively reamed to accommodate extra-large cups. Oblong cups, which take advantage of the oval-shaped cavity resulting from many failed acetabular components, can also be used. The success of these cementless techniques depends on the degree and location of bone loss. The correct indication to revision and the choice of the correct implant is the keystone for the success of this type of surgery and follows an accurate preoperative planning in order to understand the specific pathologic scenario. The aim of this paper is to review some technical options for the revision of the acetabular component also taking into account our personal experiences and series.