Acta Ortopédica Mexicana

González UH, Ilizaliturri SVM, Camacho GJ, Rojas PC, Izaguirre A
Functional outcomes in patients subjected to acetabular revision with reinforcement rings
Acta Ortop Mex 2010; 24 (4)

Language: Español
References: 13
Page: 230-234
PDF: 0. Kb.

[Fulltext - PDF]

ABSTRACT

Background: total hip arthroplasty is the most successful orthopedic procedure and the frequency of use of revision components has grown exponentially. The increased number of revisions results from the longer life expectancy of the population and the greater frequency of the hip arthroplasty indication among young patients. The purpose of this study is to evaluate the functional results of patients subjected to revision of the acetabular component using reinforcement rings. Material and methods: the study included patients with a diagnosis of septic or aseptic prosthetic loosening and sequelae of acetabular fractures between January 2007 and November 2009 in whom a reinforcement ring was used. The WOMAC scale was used for the functional evaluation. Results: according to the WOMAC scale, the patient functionality results showed a mean preoperative score of 41.89 and a mean postoperative score of 74.26, which represented an improvement of 33.11 points in the median of patients subjected to the surgical intervention, with a statistically significant difference (p = 0.036). Discussion: this study shows an improvement in the functionality of the patients subjected to surgery with a reinforcement ring, as, first and foremost, a statistically significant difference was seen between the preoperative and postoperative values and, secondly, there are papers published in the literature showing that a difference of more than 12 points between the preoperative and postoperative scores in the WOMAC scale indicates a significant clinical improvement of patients. Conclusion: patients subjected to acetabular revision with a reinforcement ring together with cemented polyethylene have an improved quality of life after the surgical intervention.


Key words: arthroplasty, hip, function, evaluation, prosthesis.


REFERENCES

  1. Davidson D, Pike J, Garbuz D, Duncan CP, Masri BA: Intraoperative periprosthetic fractures during total hip arthroplasty. Evaluation and management. J Bone Joint Surg Am 2008; 90: 2000-12.

  2. Sporer SM, Paprosky WG, O’Rourke M: Managing bone loss in acetabular revision. J Bone Joint Surg 2005; 87: 1609-18.

  3. Sporer SM, O’Rourke M, Paprosky WG: The Treatment of pelvic discontinuity during acetabular revision. J Arthroplasty 2005; 20 (4 Suppl 2): 79-84.

  4. Paprosky WG, Weeden SH, Bowling JW Jr: Component removal in revision total hip arthroplasty. Clin Orthop Relat Res 2001; (393):181-93.

  5. Berry DJ: Identification and management of pelvic discontinuity. Orthopedics 2001; 24: 881.

  6. Barrack RL, Sawhney J, Hsu J, et al: Cost analysis of revision total hip arthroplasty. Clin Orthop 1999; 369: 175-8.

  7. Paprosky WG, Perona PG, Lawrence JM: Acetabular defect classification and surgical reconstruction in revision arthroplasty. A 6-year follow-up evaluation. J Arthroplasty 1994; 9: 33-44.

  8. Berry DJ, Lewallen DG, Hanssen AD, et al: Pelvic discontinuity in revision total hip arthroplasty. J Bone Joint Surg Am 1999; 81: 1692.

  9. Bellamy N, Buchanan WW. Goldsmith CH, Campbell J, Stitt LW: Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes of anti-rheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 1988; 15: 1833-40.

  10. Engh CA Jr, Culpepper WJ 2nd, Engh CA: Long-term results of use of the anatomic medullary locking prosthesis in total hip arthroplasty. J Bone Joint Surg Am 1997; 79(2): 177-84.

  11. Goodman S, Saastamoinen H, Shasha N, Gross A: Complications of ilioischial reconstruction rings in revision total hip arthroplasty. J Arthroplasty 2004; 19: 436-46.

  12. Winter E, Piert M, Volkmann R, et al: Allogenic cancellous bone graft and a Burch-Schneider ring for acetabular reconstruction in revision hip arthroplasty. J Bone Joint Surg [Am] 2001; 83-A: 862-7.

  13. Ehrich EW, Davies GM, Watson DJ, Bolognese JA, Seidenberg BC, Bellamy N: Minimal perceptible clinical improvement with the western Ontario and McMaster Universities osteoarthritis index questionnaire and global assessments in patients with osteoarthritis. J Rheumatol 2000; 27: 2635-41.