TY  - JOUR
A1  - Prodinger, Peter Michael
A1  - Lazic, Igor
A1  - Horas, Konstantin
A1  - Burgkart, Rainer
A1  - von Eisenhart-Rothe, Rüdiger
A1  - Weissenberger, Manuel
A1  - Rudert, Maximilian
A1  - Holzapfel, Boris Michael
T1  - Revision Arthroplasty Through the Direct Anterior Approach Using an Asymmetric Acetabular Component
JF  - Journal of Clinical Medicine
N2  - Despite increasing numbers of primary hip arthroplasties performed through the direct anterior approach (DAA), there is a lack of literature on DAA revision arthroplasty. The present study was performed in order to evaluate outcomes and revision rates after revision through the DAA using an asymmetric acetabular component with optional intra- and extramedullary fixation. In a retrospective cohort study, we analyzed prospectively collected data of 57 patients (61 hips, 43 female, 18 male) who underwent aseptic acetabular component revision through the DAA with the abovementioned implant system between January 2015 and December 2017. The mean follow-up was 40 months (12–56). Survival rates were estimated using the Kaplan–Meier method. All complications were documented and functional outcomes were assessed pre- and postoperatively. Kaplan–Meier analysis revealed an estimated five-year implant survival of 97% (confidence interval CI 87–99%). The estimated five-year survival with revision for any cause was 93% (CI 83–98%). The overall revision rate was 6.6% (n = 4). Two patients had to undergo revision due to periprosthetic infection (3.3%). In one patient, the acetabular component was revised due to aseptic loosening four months postoperatively. Another patient suffered from postoperative iliopsoas impingement and was treated successfully by arthroscopic iliopsoas tenotomy. Two (3.3%) of the revised hips dislocated postoperatively. The mean Harris Hip Score improved from 35 (2–66) preoperatively to 86 (38–100) postoperatively (p < 0.001). The hip joint’s anatomical center of rotation was restored at a high degree of accuracy. Our findings demonstrate that acetabular revision arthroplasty through the DAA using an asymmetric acetabular component with optional intra- and extramedullary fixation is safe and practicable, resulting in good radiographic and clinical midterm results.
KW  - anterior approach
KW  - revision arthroplasty
KW  - hip joint
KW  - acetabular bone defect
KW  - asymmetric implant
KW  - anatomic center of rotation
Y1  - 2020
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-213184
SN  - 2077-0383
VL  - 9
IS  - 9
ER  -