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Isolated Acetabular Revision with Use of the Harris-Galante Cementless ComponentStudy with Intermediate-Term Follow-up
Amir A. Jamali, MD1; Danton S. Dungy, MD2; Arthur Mark, MD3; Steven Schule, MD4; William H. Harris, MD5
1 Department of Orthopaedic Surgery, UC Davis Medical Center, 4860 Y Street, Suite 3800, Sacramento, CA 95817. E-mail address: amir.jamali@ucdmc.ucdavis.edu
2 Associated Bone and Joint Surgeons, 1500 South Dobson Road, Suite 113, Mesa, AZ 85202. E-mail address: dsdungy@aol.com
3 Seaview Orthopaedics, 2040 Sixth Avenue, Neptune, NJ 07753. E-mail address: artmarkmd@yahoo.com
4 Buenaventura Orthopaedics, 2600 East Main Street, Ventura, CA 93001. E-mail address: orifmd@yahoo.com
5 Department of Orthopaedic Surgery, Massachusetts General Hospital, Jackson 1126, 55 Fruit Street, Boston, MA 02114. E-mail address: wharris.obbl@partners.org
View Disclosures and Other Information
The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. One or more of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity (Zimmer, Inc., Warsaw, Indiana). In addition, a commercial entity (Zimmer, Inc.) paid or directed, or agreed to pay or direct, benefits to a research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.
Investigation performed at the Orthopaedics Biomechanics and Biomaterials Laboratory and the Adult Reconstruction Unit, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2004 Aug 01;86(8):1690-1697
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Abstract

Background: Isolated revision of an acetabular total hip component is associated with special problems related to the retention of the femoral component. We reviewed the intermediate-term results of a series of such operations with use of the Harris-Galante Porous acetabular component.

Methods: We retrospectively studied the results of ninety-five isolated acetabular revisions, specifically focusing on sixty-three that had been followed for a minimum of sixty months (average, 130 months). Evaluation measures included the Harris hip score, radiographic analysis, complications, and prosthetic survival. Follow-up information was obtained with self-administered questionnaires, telephone contact, and/or clinical examination. The effects of a femoral component with a modular neck-head junction and of trochanteric osteotomy on the dislocation rate were evaluated.

Results: Nine shells were rerevised: four because of recurrent dislocation, four because of aseptic loosening, and one because of dissociation of the liner. The survival rate with rerevision of the shell as the end point was 90.5% at 120 months. Pelvic osteolysis occurred in 4% of the cases. The dislocation rate for the sixty-three hips was 8%. When femoral component modularity was accounted for, the analysis of the dislocations revealed a significantly higher dislocation rate for the hips without a trochanteric osteotomy (p = 0.04). Eight arthroplasties were complicated by nerve palsies, seven of which resolved fully or nearly so.

Conclusions: Isolated acetabular revision with use of the Harris-Galante Porous acetabular component was associated with a low rate of loosening, lysis, and rerevision of the shell at the time of intermediate-term follow-up. However, there was a high rate of complications, including trochanteric nonunion, dislocation, and nerve palsy. The performance of a trochanteric osteotomy was associated with a decreased rate of dislocation.

Level of Evidence: Therapeutic study, Level IV (case series [no, or historical, control group]). See Instructions to Authors for a complete description of levels of evidence.

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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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