Universität zu Köln

Froeschen, Frank S., Randau, Thomas M., Gravius, Nadine, Wirtz, Dieter C., Gravius, Sascha and Walter, Sebastian G. (2022). Risk factors for implant failure of custom-made acetabular implants in patients with Paprosky III acetabular bone loss and combined pelvic discontinuity. Technol. Health Care, 30 (3). S. 703 - 712. AMSTERDAM: IOS PRESS. ISSN 1878-7401

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Abstract

BACKGROUND: Severe acetabular bone loss in revision total hip arthroplasty (RTHA), both with or without pelvic discontinuity, remains a great challenge in orthopaedic surgery. OBJECTIVE: The aim of this study was to evaluate risk factors for failure of custom-made acetabular implants in RTHA. METHODS: Seventy patients with severe acetabular bone loss (Paprosky Type III) and pelvic discontinuity, who required RTHA, were included in our study. All prostheses were constructed based on a thin-layer computed-tomography (CT) scan of the pelvis. The treatment was considered unsuccessful in the event of periprosthetic joint infection (PJI) or aseptic loosening (AL) with need for explantation of the custom-made acetabular implant. RESULTS: The average follow-up was 41.9 +/- 34.8 months (range 1.5-120). Implant survival at last follow-up was 75.7% (53 of 70). Explantation was necessary in 17 cases (15 PJI; 2 AL). Previous PJI as reason for RTHA (p = 0.025; OR 3.56 (95% CI: 1.14; 11.21)), additional revision of femoral components (p = 0.003; OR 8.4 (95% CI: 1.75; 40.42)), rheumatoid disease (p = 0.039; OR 3.43 (95% CI: 1.01; 11.40)), elevated preoperative CRP > 15.2 mg/l (p = 0.015; AUC: 0.7) and preoperative haemoglobin < 10.05 (p = 0.022; AUC: 0.69) were statistically significant risk factors associated with treatment failure. Age and BMI were not statistically significant contributing to implant failure. CONCLUSION: Risk factors for treatment failure were a previous PJI, additional revision of femoral component, rheumatoid disease, elevated preoperative CRP and low preoperative haemoglobin. Awareness of these risk factors will help to improve future treatment standards.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Froeschen, Frank S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Randau, Thomas M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gravius, Nadine UNSPECIFIED UNSPECIFIED UNSPECIFIED Wirtz, Dieter C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gravius, Sascha UNSPECIFIED UNSPECIFIED UNSPECIFIED Walter, Sebastian G. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-673668
DOI:	10.3233/THC-202236
Journal or Publication Title:	Technol. Health Care
Volume:	30
Number:	3
Page Range:	S. 703 - 712
Date:	2022
Publisher:	IOS PRESS
Place of Publication:	AMSTERDAM
ISSN:	1878-7401
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language TOTAL HIP-ARTHROPLASTY; RECONSTRUCTION; INFECTION; MANAGEMENT; COMPONENT; DEFECT Multiple languages Health Care Sciences & Services; Engineering, Biomedical Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/67366