Background: Isolated revision of an acetabular total hip component
is associated with special problems related to the retention of the femoral
component. We reviewed the intermediate-term results of a series of such
operations with use of the Harris-Galante Porous acetabular component.
Methods: We retrospectively studied the results of ninety-five
isolated acetabular revisions, specifically focusing on sixty-three that had
been followed for a minimum of sixty months (average, 130 months). Evaluation
measures included the Harris hip score, radiographic analysis, complications,
and prosthetic survival. Follow-up information was obtained with
self-administered questionnaires, telephone contact, and/or clinical
examination. The effects of a femoral component with a modular neck-head
junction and of trochanteric osteotomy on the dislocation rate were
evaluated.
Results: Nine shells were rerevised: four because of recurrent
dislocation, four because of aseptic loosening, and one because of
dissociation of the liner. The survival rate with rerevision of the shell as
the end point was 90.5% at 120 months. Pelvic osteolysis occurred in 4% of the
cases. The dislocation rate for the sixty-three hips was 8%. When femoral
component modularity was accounted for, the analysis of the dislocations
revealed a significantly higher dislocation rate for the hips without a
trochanteric osteotomy (p = 0.04). Eight arthroplasties were complicated by
nerve palsies, seven of which resolved fully or nearly so.
Conclusions: Isolated acetabular revision with use of the
Harris-Galante Porous acetabular component was associated with a low rate of
loosening, lysis, and rerevision of the shell at the time of intermediate-term
follow-up. However, there was a high rate of complications, including
trochanteric nonunion, dislocation, and nerve palsy. The performance of a
trochanteric osteotomy was associated with a decreased rate of
dislocation.
Level of Evidence: Therapeutic study, Level IV (case
series [no, or historical, control group]). See Instructions to Authors for a
complete description of levels of evidence.