Midterm Survivorship After Revision Total Hip Arthroplasty With a Custom Triflange Acetabular Component.

BACKGROUND: Custom triflange acetabular components are being increasingly used for the reconstruction of Paprosky type IIIB acetabular defects. However, midterm survivorship data are lacking.

METHODS: We queried the prospective registries at 2 high-volume revision centers for patients who had undergone revision total hip arthroplasty using a custom triflange component between 2000 and 2011. We identified 73 patients with minimum 5-year follow-up. These patients' records were reviewed to determine incidence of revision or reoperation, clinical performance, and radiographic stability. The mean follow-up was 7.5 years (range 5-12 years).

RESULTS: Fifteen of 73 triflange components (20.5%) were indicated for revision during the follow-up period, including 6 for instability (8%) and 8 for infection (11%). Twelve of 73 patients (16%) underwent reoperation for reasons other than failure of the triflange component. The median hip disability and osteoarthritis outcome score for joint replacement score at midterm follow-up was 85 (interquartile range 73-100). Only 1 of 73 implants was determined to be radiographically loose at midterm follow-up.

CONCLUSION: Custom triflange reconstruction for severe acetabular deficiency is a viable option; however, complications are common and significant challenges remain for those that fail.