Outcome of Patients Treated With Porous Tantalum Acetabular Implants for Neoplastic Periacetabular Lesions. Issue 6 (15th March 2020)

• Record Type: Journal Article
• Authors: Houdek, Matthew T.; Abdel, Matthew P.; Perry, Kevin I.; Salduz, Ahmet; Rose, Peter S.; Sim, Franklin H.; Lewallen, David G.
• Is Part Of: Journal of the American Academy of Orthopaedic Surgeons. Volume 28:Issue 6(2020)
• Publication Date: 2020-03-15
• Subjects: Orthopedics -- Periodicals; Orthopedic surgery -- Periodicals; Joint Diseases -- Periodicals; Orthopedics -- Periodicals; Orthopedic surgery; Orthopedics; Periodicals; 616.7005
• DOI: 10.5435/JAAOS-D-18-00482
• Languages: English
• ISSNs: 1067-151X

Abstract

Abstract : Introduction: The periacetabular region is a common location for nonprimary neoplastic tumors. Although these tumors were historically treated with a cemented acetabular implant, we previously reported on the short-term follow-up on the use of a tantalum acetabular shell to reconstruct these defects. This study expands our previous report on longer follow-up, with specific emphasis on patient and implant survivorship, radiographic results, and clinical outcomes. Methods: Fifty-eight patients (32 women and 26 men) were treated using a tantalum acetabular implant and total hip arthroplasty to reconstruct a nonprimary neoplastic process between 2001 and 2014. The mean age and body mass index were 62 years and 28 kg/m 2, respectively. The most common diagnosis was metastatic disease (n = 29). The patients' medical records and radiographs were reviewed to assess Harris hip scores and radiographic fixation. The mean follow-up for surviving patients was 8 years. Results: At the most recent follow-up, 41 patients were dead of the disease and 17 were alive with the disease and no cases of acetabular implant revision were reported. Two patients had a progressive radiolucent line; however, they also had radiographic evidence of local disease progression. After reconstruction, patients had a significant ( P = 0.0001) increase in their Harris hip score (37 vs. 72). Discussion: In patients with periacetabular metastatic diseases and hematologic malignancies treated with total hip arthroplasty, a highly porous tantalum revision-type shell fixed with multiple screws, and supplemental support with acetabular augments or cup-cage reinforcement, can successfully provide patients with a stable, well-fixed, and durable construct, with no cases of mechanical failure at mid-term follow-up.