Acetabular Revision with Oblong Cup

초록

Acetabular Revision with Oblong Cup Massive deficiency of acetabular bone stock is a challenging problem in the increasing number of patients who require revision of failed hip arthroplasty. Loss of acetabular bone stock causes two major problems: 1) obtaining secure acetabular fixation, and 2) alteration of hip center which creats difficulty resoring limb length, normal hip mechanism, and hip joint instability. There are several methods of reconstruction available, depending upon the characteristics of the bone loss and preference and experience of individual surgeons. These options include the use of a structual allograft, a bipolar prosthesis with particulate bone graft, an oversized cementless hemispherical cup, a small cementless hemispherical cup located high hip in pelvis, an protrusio cage and reinforcement ring, or an oblong or bilobed shaped cementless cup. Several recent studies suggest that acetabular revision using a standard porous-coated hemispherical cup provided excellent results when acetabular recess has an intact rim of bone present. However, all cases can not be treated with this technique. The bilobed cup has been presented as one of many alternative techniques for those cases in which a porous-cated hemispherical cup cannot be used. The purpose of this lecture is to introduce the design rationale, surgical technique, clinical results and adequate indication of the oblong or bilobed cup.