The Use of Porous Titanium Metal Augments for Acetabular Defects in Total Hip Arthroplasty: Initial Results From a Single-Center Experience

TL;DR

This study evaluates the effectiveness of using porous titanium metal augments to address acetabular bone defects during hip replacement surgery.

Contribution

The study presents initial clinical results from a single-center experience using porous metal augments for acetabular defects.

Findings

Porous titanium metal augments were used successfully in 30 patients with acetabular bone defects.

Significant improvement in hip function was observed using the Modified Harris Hip Score.

Complications occurred in 16% of cases, indicating a generally reliable surgical method.

Abstract

Background and objective

One of the major challenges that orthopaedic surgeons face during revision total hip arthroplasty (THA) is the presence of acetabular bone defects. Nowadays, preference is given to metal augments when it comes to segmental, uncontained defects. This study aimed to present the previous experience at our hospital in the use of porous metal augments for bony defects of the acetabulum.

Methods

Our retrospective observational study included a total of 30 patients who underwent revision or primary THA with the use of porous metal acetabular augmentation between 2021 and 2024. The extent and localization of acetabular bone defects were assessed on preoperative X-ray series and CT scans, confirmed intraoperatively, and classified using the Paprosky classification. The functional status of the patients was evaluated using the Modified Harris Hip Score (mHHS). The complications were defined as adverse outcomes requiring rehospitalization and further treatment. Statistical data analysis was performed using SPSS Statistics version 28.0 (IBM Corp., Armonk, NY).

Results

Surgeries were performed by 14 different orthopaedic surgeons, using a posterolateral hip approach in all cases. Pinnacle Multihole® cementless acetabular shell and Gription® TF augment (DePuy Synthes, Raynham, MA) were implanted in all patients. Revision of the acetabular component was indicated due to mechanical complications in 19 patients (64%), and periprosthetic infection in nine (30%) patients. In two cases (6%) metal augment was used in primary hip arthroplasty. As for acetabular defects, Paprosky type IIb defect was observed in nine cases (30%), type IIc in five cases (16%), type IIIa in 12 (40%), and type IIIb defect in four cases (14%). The analysis of mHHS showed a significant improvement after the operative treatment and the completion of the rehabilitation. Complications of surgical treatment were observed in five patients (16%).

Conclusions

Based on our findings, the use of metal augments is a reliable surgical method that enables the surgeon to deal with various defects of the acetabulum bone mass, ensuring the establishment of favourable biomechanical conditions in the hip joint.

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