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

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

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).

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.

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