Hip & pelvis

  • 제35권2호
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  • Pages.122-132
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  • 2023
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  • 2287-3260(pISSN)
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  • 2287-3279(eISSN)
대한고관절학회 (The Korean Hip Society)
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The Dome Technique for Managing Massive Anterosuperior Medial Acetabular Bone Loss in Revision Total Hip Arthroplasty: Short-Term Outcomes

  • Tyler J. Humphrey (Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School) ;
  • Colin M. Baker (Rothman Orthopaedic Institute at Thomas Jefferson University) ;
  • Paul M. Courtney (Rothman Orthopaedic Institute at Thomas Jefferson University) ;
  • Wayne G. Paprosky (Department of Orthopaedic Surgery, Section of Adult Joint Reconstruction, Rush Presbyterian-St. Luke's Medical Center) ;
  • Hany S. Bedair (Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School) ;
  • Neil P. Sheth (Pennsylvania Hospital, Hospital of the University of Pennsylvania) ;
  • Christopher M. Melnic (Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School)
  • 투고 : 2022.12.07
  • 심사 : 2023.03.03
  • 발행 : 2023.06.30
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초록

Purpose: The dome technique is a technique used in performance of revision total hip arthroplasty (THA) involving intraoperative joining of two porous metal acetabular augments to fill a massive anterosuperior medial acetabular bone defect. While excellent outcomes were achieved using this surgical technique in a series of three cases, short-term results have not been reported. We hypothesized that excellent short-term clinical and patient reported outcomes could be achieved with use of the dome technique. Materials and Methods: A multicenter case series was conducted for evaluation of patients who underwent revision THA using the dome technique for management of Paprosky 3B anterosuperior medial acetabular bone loss from 2013-2019 with a minimum clinical follow-up period of two years. Twelve cases in 12 patients were identified. Baseline demographics, intraoperative variables, surgical outcomes, and patient reported outcomes were acquired. Results: The implant survivorship was 91% with component failure requiring re-revision in only one patient at a mean follow-up period of 36.2 months (range, 24-72 months). Three patients (25.0%) experienced complications, including re-revision for component failure, inter-prosthetic dual-mobility dissociation, and periprosthetic joint infection. Of seven patients who completed the HOOS, JR (hip disability and osteoarthritis outcome score, joint replacement) survey, five patients showed improvement. Conclusion: Excellent outcomes can be achieved using the dome technique for management of massive anterosuperior medial acetabular defects in revision THA with survivorship of 91% at a mean follow-up period of three years. Conduct of future studies will be required in order to evaluate mid- to long-term outcomes for this technique.

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참고문헌

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