Skip to main content

Advertisement

SpringerLink
Log in

Acetabular reinforcement ring in primary total hip arthroplasty: a minimum 10-year follow-up

  • Orthopaedic Outcome Assessment
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

We report the results of a titanium acetabular reinforcement ring with a hook (ARRH) in primary total hip arthroplasty (THA), which was introduced in 1987 and continues to be used routinely in our center. The favorable results of this device in arthroplasty for developmental dysplasia and difficult revisions motivated its use in primary THA. With this implant only minimal acetabular reaming is necessary, anatomic positioning is achieved by placing the hook around the teardrop and a homogenous base for cementing the polyethylene cup is provided.

Materials and methods

Between April 1987 and December 1991, 241 THAs with insertion of an ARRH were performed in 178 unselected, consecutive patients (average age 58 years; range 30–84 years) with a secondary osteoarthrosis in 41% of the cases.

Results

At the time of the latest follow-up, 33 patients (39 hips) had died and 17 cases had been lost to follow-up. The median follow-up was 122 months with a minimum of 10 years. Eight hips had been revised, leaving 177 hips in 120 living patients without revision. Six cups were revised because of aseptic loosening. Two hips were revised for sepsis. The mean Merle d’Aubigné score for the remaining hips was 16 (range 7–18) at the latest follow-up. For aseptic loosening, the probability of survival of the cup was 0.97 (95% confidence interval, 0.94–0.99). However, analysis of radiographs implied loosening in seven other cups without clinical symptoms.

Conclusions

The results of primary THA using an acetabular reinforcement ring parallel the excellent results of these implants often observed in difficult primary and revision arthroplasty at a minimum of 10 years. Survivorship is comparable to modern cementless implants. Medial migration that occurs with loosening of the acetabular component seems to be prevented with this implant. Radiographic loosening signs can exist without clinical symptoms.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Abbreviations

THA:

Total hip arthroplasty

ARRH:

Acetabular reinforcement ring with hook

OA:

Osteoarthritis

References

  1. Aebi M, Richner L, Ganz R (1989) Long term results of primary hip total prosthesis with acetabulum reinforcement ring. Orthopäde 18:504–510 (In German)

    PubMed  CAS  Google Scholar 

  2. Aldinger PR, Thomsen M, Lukoschek M, Mau H, Ewerbeck V, Breusch SJ (2004) Long-term fate of uncemented, threaded acetabular components with smooth surface treatment: minimum 10-year follow-up of two different designs. Arch Orthop Trauma Surg 124:469–475

    Article  PubMed  Google Scholar 

  3. Archibeck MJ, Berger RA, Jacobs JJ, Quigley LR, Gitelis S, Rosenberg A, Galante JO (2001) Second-generation cementless total hip arthroplasty. J Bone Joint Surg Am 83:1666–1673

    PubMed  Google Scholar 

  4. Bauer R, Kerschbaumer F, Poisel S, Oberthaler W (1979) The transgluteal approach to the hip joint. Arch Orthop Trauma Surg 95:47–49

    Article  PubMed  CAS  Google Scholar 

  5. Blacha J (2004) High osteolysis and revision rate with the hydroxyapatite-coated ABG hip prostheses: 65 hips in 56 young patients followed for 5–9 years. Acta Orthop Scand 75:276–282

    Article  PubMed  Google Scholar 

  6. Brooker AF, Bowerman JW, Robinson RA, Riley LH (1973) Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg Am 55:1629–1632

    PubMed  CAS  Google Scholar 

  7. Castoldi F, Rossi R, La Russa M, Sibelli P, Rossi P, Ranawat AS (2007) Ten-year survivorship of the Anatomique Benoist Girard I total hip arthroplasty. J Arthroplasty 22:363–368

    Article  PubMed  Google Scholar 

  8. Clohisy JC, Harris WH (1999) The Harris–Galante uncemented femoral component in primary total hip replacement at 10 years. J Arthroplasty 14:915–917

    Article  PubMed  CAS  Google Scholar 

  9. Cox DR (1972) Regression models and life-tables (with discussion). J Roy Statist Soc Ser B Method 34:187–220

    Google Scholar 

  10. Garcia-Rey E, Garcia-Cimbrelo E (2007) Long-term results of uncemented acetabular cups with an ACS polyethylene liner. A 14–16-year follow-up study. Int Orthop 31:205–210

    Article  PubMed  CAS  Google Scholar 

  11. Gerber A, Pisan M, Zurakowski D, Isler B (2003) Ganz reinforcement ring for reconstruction of acetabular defects in revision total hip arthroplasty. J Bone Joint Surg Am 85:2358–2364

    PubMed  Google Scholar 

  12. Goodman SB, Adler SJ, Fyhrie DP, Schurman DJ (1988) The acetabular teardrop and its relevance to acetabular migration. Clin Orthop Relat Res 236:199–204

    PubMed  Google Scholar 

  13. Grübl A, Chiari C, Gruber M, Kaider A, Gottsauner-Wolf F (2002) Cementless total hip arthroplasty with a tapered, rectangular titanium stem and a threaded cup: a minimum 10-year follow-up. J Bone Joint Surg Am 84:425–431

    PubMed  Google Scholar 

  14. Gurtner P, Aebi M, Ganz R (1993) The acetabular roof cup in revision arthroplasty of the hip. Z Orthop Ihre Grenzgeb 131:594–600 (In German)

    Article  PubMed  CAS  Google Scholar 

  15. Haentjens P, de Boeck H, Handelberg F, Casteleyn PP, Opdecam P (1993) Cemented acetabular reconstruction with the Müller support ring. A minimum 5-year clinical and roentgenographic follow-up study. Clin Orthop Relat Res 290:225–235

    PubMed  Google Scholar 

  16. Hendrich C, Mehling I, Sauer U, Kirschner S, Martell JM (2006) Cementless acetabular reconstruction and structural bone-grafting in dysplastic hips. J Bone Joint Surg Am 88:387–394

    Article  PubMed  CAS  Google Scholar 

  17. Hosmer DW, Lemeshow S (1999) Applied logistic regression. Wiley, New York, pp 40–52

    Google Scholar 

  18. Johnston RC, Fitzgerald RH, Harris WH, Müller ME, Sledge CB (1990), Clinical and radiographic evaluation of total hip replacement. J Bone Joint Surg Am 72:161–168

    PubMed  CAS  Google Scholar 

  19. Kaplan E, Meier P (1958) Nonparametric estimation from incomplete observations. J Am Stat Assoc 53:457–481

    Article  Google Scholar 

  20. Kawamura H, Dunbar MJ, Murray P, Bourne RB, Rorabeck CH (2001) The porous coated anatomic total hip replacement: a ten to fourteen-year follow-up study of a cementless total hip arthroplasty. J Bone Joint Surg Am 83:1333–1338

    PubMed  Google Scholar 

  21. Koch PP, Tannast M, Fujita H, Siebenrock KA and Ganz R (2008) Minimum ten year results of total hip arthroplasty with the acetabular reinforcement ring in avascular osteonecrosis. Int Orthop, in press

  22. Livermore J, Ilstrup D, Morrey B (1990) Effect of femoral head size on wear of the polyethylene acetabular component. J Bone Joint Surg Am 72:518–528

    PubMed  CAS  Google Scholar 

  23. Madey SM, Callaghan JJ, Olejniczak JP, Goetz DD, Johnston RC (1997) Charnley total hip arthroplasty with use of improved techniques of cementing. The results after a minimum of fifteen years of follow-up. J Bone Joint Surg Am 79:53–64

    Article  PubMed  CAS  Google Scholar 

  24. McAuley JP, Moore KD, Culpepper WJ, Engh CA (1998) Total hip Arthroplasty with porous-coated prostheses fixed without cement in patients who are sixty-five years of age or older. J Bone Joint Surg Am 80:1648–1655

    PubMed  CAS  Google Scholar 

  25. Merle d’Aubigné R, Postel M (1954) Functional results of hip arthroplasty with acrylic prosthesis. J Bone Joint Surg Am 36:451–475

    Google Scholar 

  26. Mulroy RD, Harris WH (1990) Failure of acetabular autogenous grafts in total hip arthroplasty. Increasing incidence: a follow-up note. J Bone Joint Surg Am 72:1536–1540

    PubMed  Google Scholar 

  27. Older J (1986) Low-friction arthroplasty of the hip. A 10–12-year follow-up study. Clin Orthop Relat Res 211:36–42

    PubMed  Google Scholar 

  28. Oosterbos CJ, Rahmy AI, Tonino AJ, Witpeerd W (2004) High survival rate of hydroxyapatite-coated hip prostheses: 100 consecutive hips followed for 10 years. Acta Orthop Scand 75:127–133

    Article  PubMed  Google Scholar 

  29. Pagnano MW, Hanssen AD, Lewallen DG, Shaughnessy WJ (1996) The effect of superior placement of the acetabular component on the rate of loosening after total hip arthroplasty. Long-term results in patients who have Crowe type-II congenital dysplasia of the hip. J Bone Joint Surg Am 78:1004–1014

    PubMed  CAS  Google Scholar 

  30. Raut VV, Siney PD, Wroblewski BM (1996) Revision of the acetabular component of a total hip arthroplasty with cement in young patients without rheumatoid arthritis. J Bone Joint Surg Am 78:1853–1856

    PubMed  CAS  Google Scholar 

  31. Reikeras O, Gunderson RB (2006) Long-term results of HA coated threaded versus HA coated hemispheric press fit cups: 287 hips followed for 11 to 16 years. Arch Orthop Trauma Surg 126:503–508

    Article  PubMed  Google Scholar 

  32. Rosson J, Schatzker J (1992) The use of reinforcement rings to reconstruct deficient acetabula. J Bone Joint Surg Br 74:716–720

    PubMed  CAS  Google Scholar 

  33. Shetty AA, Slack R, Tindall A, James KD, Rand C (2005) Results of a hydroxyapatite-coated (Furlong) total hip replacement: a 13- to 15-year follow-up. J Bone Joint Surg Br 87:1050–1054

    Article  PubMed  CAS  Google Scholar 

  34. Siebenrock KA, Tannast M, Kim S, Morgenstern W, Ganz R (2005) Acetabular reconstruction using a roof reinforcement ring with hook for total hip arthroplasty in developmental dysplasia of the hip-osteoarthritis minimum 10-year follow-up results. J Arthroplasty 20:492–498

    Article  PubMed  Google Scholar 

  35. Siebenrock KA, Trochsler M, Sadri H, Ganz R (2001) Hooked roof cup in revision of difficult loose hip prosthesis cups. Results after a minimum of 10 years. Orthopäde 30:273–279 (In German)

    Article  PubMed  CAS  Google Scholar 

  36. Smith SE, Harris WH (1997) Total hip arthroplasty performed with insertion of the femoral component with cement and the acetabular component without cement. Ten to thirteen-year results. J Bone Joint Surg Am 79:1827–1833

    Article  PubMed  CAS  Google Scholar 

  37. Stockl B, Beerkotte J, Krismer M, Fischer M, Bauer R (1997) Results of the Müller acetabular reinforcement ring in revision arthroplasty. Arch Orthop Trauma Surg 116:55–59

    Article  PubMed  CAS  Google Scholar 

  38. Surdam JW, Archibeck MJ, Schultz SC, Junick DW, White RE (2007), A second-generation cementless total hip arthroplasty mean 9-year results. J Arthroplasty 22:204–209

    Article  PubMed  Google Scholar 

  39. Tannast M, Langlotz U, Siebenrock KA, Wiese M, Bernsmann K, Langlotz F (2005) Anatomic referencing of cup orientation in total hip arthroplasty. Clin Orthop 436:144–150

    PubMed  Google Scholar 

  40. Thomas BJ, Saa J, Lane JM (1996) Total hip arthroplasty. Curr Opin Rheumatol 8:148–153

    Article  PubMed  CAS  Google Scholar 

  41. Wroblewski BM, Fleming PA, Siney PD (1999) Charnley low-frictional torque arthroplasty of the hip: 20- to 30-year results. J Bone Joint Surg Br 81:427–430

    Article  PubMed  CAS  Google Scholar 

  42. Wroblewski BM, Siney PD (1993) Charnley low-friction arthroplasty of the hip. Long-term results. Clin Orthop Relat Res 292:191–201

    PubMed  Google Scholar 

  43. Xenos JS, Callaghan JJ, Heekin RD, Hopkinson WJ, Savory CG, Moore MS (1999) The porous-coated anatomic total hip prosthesis, inserted without cement. A prospective study with a minimum ten years of follow-up. J Bone Joint Surg Am 81:74–82

    PubMed  CAS  Google Scholar 

  44. Zehntner MK, Ganz R (1994) Midterm results (5.5–10 years) of acetabular allograft reconstruction with the acetabular reinforcement ring during total hip revision. J Arthroplasty 9:469–479

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Inselspital, University of Bern, 3010, Bern, Switzerland

    Hassan Sadri, Grégoire Pfander, Klaus-Arno Siebenrock, Moritz Tannast, Peter Koch, Hiroshi Fujita & Reinhold Ganz

  2. Clinic for Orthopaedic Surgery, Spital Thun, Thun, Switzerland

    Peter Ballmer

Authors
  1. Hassan Sadri
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Grégoire Pfander
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Klaus-Arno Siebenrock
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Moritz Tannast
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Peter Koch
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hiroshi Fujita
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Peter Ballmer
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Reinhold Ganz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Moritz Tannast.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sadri, H., Pfander, G., Siebenrock, KA. et al. Acetabular reinforcement ring in primary total hip arthroplasty: a minimum 10-year follow-up. Arch Orthop Trauma Surg 128, 869–877 (2008). https://doi.org/10.1007/s00402-008-0612-z

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-008-0612-z

Keywords

Search

Navigation