PURPOSE: The aim of the present study was to introduce a novel oblong revision cup type TC for use in revision total hip arthroplasty (THA), and to evaluate mid-term results in terms of bone tissue remodelling in the immediate area of the implant. METHODS: The results of 31 patients that underwent revision THA between 2004 and 2008 are presented. The mean follow-up interval was 7.1 years (range 5.3-9.3 years, minimum of five years following revision). Osteointegration of the implant and bone tissue remodelling around the implant and ribs were assessed by X-ray and computed tomography (CT). RESULTS: The average Harris hip score increased from 39.8 to 85.3. Excellent results were achieved in nine patients, good in 16, fair in three and poor in three. According to X-ray results, 25 hips had a well-fixed, bone-ingrown cup and five had a stable fibrous union in the middle and the distal third of the implant. Proximal migration of the cup was noted in one case. Pelvic CT was additionally performed in ten patients. In all cases, we detected bone remodelling in the space between the implant ribs. Kaplan-Maier survivorship of the acetabular components was 94.2 % at 7.1 years. CONCLUSIONS: Our results show that the novel oblong revision cup type TC is relatively simple to implant, and is associated with reliable primary fixation and documented osteointegration and bone remodelling in the immediate area.

Department of Paediatric and Adult Orthopaedic Surgery and Traumatology 2nd Faculty of Medicine Charles University Prague and Motol University Hospital 5 Úvalu 84 Prague 5 154 00 Czech Republic

See more in PubMed

Cameron HU. Cavity-filling components: when round isn’t right. Orthopedics. 2001;24(9):879–880. PubMed

Cameron HU, Smula V. Use of oblong socket in hip revision surgery. Acta Chir Orthop Traumatol Cech. 1999;66(1):7–9. PubMed

Chen WM, Engh CA, Jr, Hopper RH, Jr, McAuley JP, Engh CA. Acetabular revision with use of a bilobed component inserted without cement in patients who have acetabular bone-stock deficiency. J Bone Joint Surg Am. 2000;82(2):197–206. PubMed

Civinini R, Capone A, Carulli C, Villano M, Gusso MI. Acetabular revision using a cementless oblong cup: five to ten year results. Int Orthop. 2008;32(2):189–193. doi: 10.1007/s00264-006-0307-4. PubMed DOI PMC

DeBoer DK, Christie MJ. Reconstruction of the deficient acetabulum with an oblong prosthesis: three- to seven-year results. J Arthroplasty. 1998;13(6):674–680. doi: 10.1016/S0883-5403(98)80012-0. PubMed DOI

Fousek J, Vašek P. Oblong cup in the management of aseptic loosening of the acetabular component in total hip replacement. Scand J Surg. 2007;96(4):319–324. PubMed

Garcia-Cimbrelo E, Tapia M, Martin-Hervas C. Multislice computed tomography for evaluating acetabular defects in revision THA. Clin Orthop Relat Res. 2007;463:138–143. PubMed

Götze C, Sippel C, Wendt G, Steinbeck J. Limits in cementless hip revision total hip arthroplasty. Midterm experience with an oblong revision cup. Z Orthop Ihre Grenzgeb. 2003;141(2):182–189. doi: 10.1055/s-2003-38652. PubMed DOI

Hart R, Rozkydal Z. Longterm results of poldi hip replacement. Acta Chir Orthop Traumatol Cech. 1999;66(3):139–145. PubMed

Hugate RR, Dickey ID, Chen WQ, Wood CM, Sim FH, Rock MG. Fixed-angle screws vs standard screws in acetabular prosthesis fixation: a cadaveric biomechanical study. J Arthroplasty. 2009;24(5):806–814. doi: 10.1016/j.arth.2008.04.019. PubMed DOI

Köster G, Radings S. Revision of failed acetabular components utilizing a cementless oblong cup: an average 9-year follow-up study. Arch Orthop Trauma Surg. 2009;129(5):603–608. doi: 10.1007/s00402-008-0624-8. PubMed DOI

Köster G, Willert HG, Köhler HP, Döpkens K. An oblong revision cup for large acetabular defects: design rationale and two- to seven-year follow-up. J Arthroplasty. 1998;13(5):559–569. doi: 10.1016/S0883-5403(98)90056-0. PubMed DOI

Landor I, Vavřík P, Jahoda D, Pokorný D, Popelka S, Sosna A. Oblong implants for revision total hip arthroplasty. Acta Chir Orthop Traumatol Cech. 2009;76(6):462–472. PubMed

Landor I, Vavřík P, Sosna A, Bek J. Total hip joint replacement with the Walter type of prosthesis: long-term results. Acta Chir Orthop Traumatol Cech. 2001;68(5):281–288. PubMed

Paprosky WG, Perona PG, Lawrence JM. Acetabular defect classification and surgical reconstruction in revision arthroplasty. J Arthroplasty. 1994;9(1):33–44. doi: 10.1016/0883-5403(94)90135-X. PubMed DOI

Rozkydal Z, Janíček P. Poldi-Čech cemented femoral stem in total hip arthroplasty after 25 years. Chir Orthop Traumatol Cech. 2010;77(4):284–290. PubMed

Sandgren B, Crafoord J, Garellick G, Carlsson L, Weidenhielm L, Olivecrona H. Computed tomography vs. digital radiography assessment for detection of osteolysis in asymptomatic patients with uncemented cups: a proposal for a new classification system based on computer tomography. J Arthroplasty. 2013;28(9):1608–1613. doi: 10.1016/j.arth.2013.01.029. PubMed DOI

Šťastný E, Trč T, Handl M, Frýdl J, Kopečný Z. Cementless total hip replacement type S.F.: mid-term results. Acta Chir Orthop Traumatol Cech. 2009;76(6):487–494. PubMed

Šťastný E, Trč T, Matěj D, Sekerka M. Comparison of a primary TC revision oval cup fixation by using locking head and common screws. Ortopedie. 2012;6:211–214.

Trč T, Šťastný E. Oblong acetabular cup, type TC, for revision total hip arthroplasty. Acta Chir Orthop Traumatol Cech. 2012;79(6):506–511. PubMed

Weber KI, Callaghan JJ, Goetz DD. Revision of a failed cemented total hip prosthesis with insertion of an acetabular component without cement and a femoral component with cement. A five to eight-years follow-up study. J Bone Joint Surg Am. 1996;78(7):982–994. PubMed