Download PDF
Vet Comp Orthop Traumatol 2013; 26(05): 408-415
DOI: 10.3415/VCOT-13-02-0029
Clinical Communication
Schattauer GmbH

Use of a revision cup for treatment of Zurich cementless acetabular cup loosening

Surgical technique and clinical application in 31 cases
L. Vezzoni
1   Clinica Veterinaria Vezzoni, Cremona, Italy
,
V. Montinaro
1   Clinica Veterinaria Vezzoni, Cremona, Italy
,
A. Vezzoni
1   Clinica Veterinaria Vezzoni, Cremona, Italy
› Author Affiliations
Further Information

Publication History

Received 26 February 2013

Accepted 22 May 2013

Publication Date:
23 December 2017 (online)

Also available at
    Permissions and Reprints

Summary

Loosening of the acetabular cup is one of the most common complications following total hip replacement and has an incidence rate of 1.8% to 36.8%. The objective of this study was to describe the surgical technique for the application of a cementless acetabular component specifically designed for treatment of cup loosening and preliminary clinical experience. The Kyon revision cup is composed of two components; the first is a perforated titanium outer shell with holes for 2.4 mm titanium screws, which is impacted into the acetabulum after removal of the loose cup and reaming of the acetabulum. It is secured with a variable number of screws. The second component is an inner plain titanium cup with an ultra-high-molecular-weight polyethylene insert, which is impacted into the outer shell to obtain press-fit stability. This revision cup was used in 31 dogs with cup loosening and a minimum follow-up period of six months. There were four intra-operative complications and two postoperative complications. The main intra-operative complication was difficulty inserting the inner cup into the outer shell. Postoperative complications included craniodorsal hip luxation in one dog, which was successfully managed, and cup loosening in another dog, which required explantation of the prosthesis. The main advantage of the revision cup appears to be increased implant stability afforded by screw fixation. Our initial clinical results in 31 dogs were promising; all but one dog had a successful clinical outcome.

Keywords

Total hip replacement - cementless - revision - acetabular - cup loosening

 

  • References

  • 1 Olmstead ML, Hohn RB, Turner TM. A five-year study of 221 total hip replacements in the dog. J Am Vet Med Assoc 1983; 183: 191-194.
    PubMedSearch in Google Scholar
  • 2 Montgomery RD, Milton JL, Pernell R. et al. Total hip arthroplasty for treatment of canine hip dysplasia. Vet Clin North Am Small Anim Pract 1992; 22: 703-719.
    CrossrefPubMedSearch in Google Scholar
  • 3 Massat BJ, Vasseur PB. Clinical and radiographic results of total hip arthroplasty in dogs: 96 cases (1986-1992). J Am Vet Med Assoc 1994; 205: 448-454.
    PubMedSearch in Google Scholar
  • 4 Conzemius MG, Vandervoort J. Total joint replacement in the dog. Vet Clin North Am Small Anim Pract 2005; 35: 1213-1231.
    CrossrefPubMedSearch in Google Scholar
  • 5 Bergh MS, Gilley RS, Shofer FS. et al. Complications and radiographic findings following cemented total hip replacement, a retrospective evaluation of 97 dogs. Vet Comp Orthop Traumatol 2006; 19: 172-179.
    Thieme ConnectPubMedSearch in Google Scholar
  • 6 Guerrero TG, Montavon PM. Zurich cementless total hip replacement: retrospective evaluation of 2nd generation implants in 60 dogs. Vet Surg 2009; 38: 70-80.
    CrossrefPubMedSearch in Google Scholar
  • 7 Bardet JF. Cemented total hip replacement: experience in France with the Porte Prosthesis [Precongress Communication]. ESVOT Precongress: Total hip replacement seminar. 2004. September 9 Munich, Germany: pg. 14.
    Search in Google Scholar
  • 8 Hach V, Delfs G. Initial experience with a newly developed cementless hip endoprosthesis. Vet Comp Orthop Traumatol 2009; 22: 153-158.
    Thieme ConnectPubMedSearch in Google Scholar
  • 9 DeYoung DJ, DeYoung BA, Aberman HA. et al. Implantation of an uncemented total hip prosthesis: technique and initial results of 100 arthroplasties. Vet Surg 1992; 21: 168-177.
    CrossrefPubMedSearch in Google Scholar
  • 10 Hummel DW, Lanz OI, Were SR. Complications of cementless total hip replacement: A retrospective study of 163 cases. Vet Comp Orthop Traumatol 2010; 6: 424-432.
    Thieme ConnectPubMedSearch in Google Scholar
  • 11 Vezzoni A. My last 1000 cases of Kyon total hip replacement. Special Session Presentation at the 2011 ACVS Annual Symposium. 2011. November 5 Chicago, IL:
    Search in Google Scholar
  • 12 Boudrieau RJ. Cementless Zurich Total Hip Arthroplasty: Multicentric Study. [Pre-Congress Communication]. ESVOT Pre-Congress: Total hip replacement seminar. 2004. September 9 Munich, Germany: pg. 21-25.
    Search in Google Scholar
  • 13 Peck JN. Five years clinical results using the Zurich Cementless (Kyon) total hip replacement: 150 cases. Proceedings of 14th Annual American College of Veterinary Surgeons Forum. 2004. ((MONTH, DAYS)) Denver CO, USA: pg. 292-293.
    Search in Google Scholar
  • 14 Marcellin-Little DJ, DeYoung BA, Doyhens DH. et al. Canine uncemented porous-coated anatomic total hip arthroplasty: results of a long-term prospective evaluation of 50 consecutive cases. Vet Surg 1999; 28: 10-20.
    CrossrefPubMedSearch in Google Scholar
  • 15 Dyce J. Emerging complications of the BioMedtrix cementless (BFX) total hip replacement. Proceedings of the 2009 ACVS Veterinary Symposium. 2009. October 8-10 Washington DC, USA: pg. 459-461.
    Search in Google Scholar
  • 16 Liska WD, Poteet BA. Pulmonary embolism associated with canine total hip replacement. Vet Surg 2003; 32: 178-186.
    CrossrefPubMedSearch in Google Scholar
  • 17 Andrews CM, Liska WD, Roberts DJ. Sciatic neuropraxia as a complication In 100 Consecutive canine total hip replacements. Vet Surg 2008; 37: 254-262.
    CrossrefPubMedSearch in Google Scholar
  • 18 Skurla CP, Pluhar GE, Frankel DJ. et al. Assessing the dog as a model for human total hip replacement: analysis of 38 canine cemented femoral components retrieved at post-mortem. J Bone Joint Surg Br 2005; 87-B: 120-127.
    CrossrefPubMedSearch in Google Scholar
  • 19 Skurla CP, James SP. Postmortem retrieved canine THR: femoral and acetabular component interaction. Biomed Sci Instrum 2004; 40: 255-260.
    PubMedSearch in Google Scholar
  • 20 El-Warrak AO, Olmstead ML, Von Rechenberg B. et al. A review of aseptic loosening in total hip arthroplasty. Vet Comp Orthop Traumatol 2001; 14: 115-124.
    Thieme ConnectPubMedSearch in Google Scholar
  • 21 Dyce J. Revision options in total hip replacement. Proceedings of the 2009 ACVS Veterinary Symposium. 2009. October 8-10 Washington DC, USA: pg. 633-635.
    Search in Google Scholar
  • 22 Vezzoni A. Revision of Kyon THR. Proceedings of 3rd World Veterinary Orthopaedic Congress ESVOT-VOS. 2010. September 15-18 Bologna, Italy: pg. 464-467.
    Search in Google Scholar
  • 23 Sporer SM. How to do a revision total hip arthroplasty: revision of the acetabulum. J Bone Joint Surg Am 2011; 93: 1359-1366.
    CrossrefPubMedSearch in Google Scholar
  • 24 Fink B, Grossmann A. [Technique of implantation of a cementless press-fit cup in revisions with severe bone defects] [Article in German]. Oper Orthop Traumatol 2008; 20: 157-167.
    CrossrefPubMedSearch in Google Scholar
  • 25 Deirmengian GK, Zmistowski B, O’Neil JT. et al. Management of acetabular bone loss in revision total hip arthroplasty. J Bone Joint Surg Am 2011; 93: 1842-1852.
    CrossrefPubMedSearch in Google Scholar
  • 26 Hallstrom BR, Golladay GJ. et al. Cementless acetabular revision with the Harris-Galante porous prosthesis. Results after a minimum of ten years of follow up. J Bone Joint Surg Am 2004; 86: 1007-1011.
    CrossrefPubMedSearch in Google Scholar
  • 27 Dearborn JT, Harris WH. Acetabular revision arthroplasty using so-called jumbo cementless components: an average 7-year follow-up study. J Arthroplasty 2000; 15: 8-15.
    CrossrefPubMedSearch in Google Scholar
  • 28 Whaley AL, Berry DJ, Harmsen WS. Extra-large uncemented hemispherical acetabular components for revision total hip arthroplasty. J Bone Joint Surg Am 2001; 83: 1352-1357.
    CrossrefPubMedSearch in Google Scholar
  • 29 Budsberg SC, Johnston SA, Schwarz PD. et al. Efficacy of etodolac for the treatment of osteoarthritis of the hip joints in dogs. J Am Vet Med Assoc 1999; 214: 206-210.
    PubMedSearch in Google Scholar
  • 30 Piermattei DL, Johnson KA. An Atlas of Surgical Approaches to the Bones and Joints of the Dog and Cat. Philadelphia, (Pennsylvania, USA): Elsevier; 2004
    Search in Google Scholar
  • 31 Montavon P, Tepic S. Surgical Techniques Zurich Cementless Total Hip Course Proceedings. 2001. July 19-20 University of Zurich, Switzerland:
    Search in Google Scholar
  • 32 Aman AM, Wendelburg KL. Assessment of acetabular cup positioning from a lateral radiographic projection after total hip replacement. Vet Surg 2013; 42: 406-412.
    CrossrefPubMedSearch in Google Scholar
  • 33 DeYoung DJ, Schiller RA. Radiographic criteria for evaluation of uncemented total hip replacement in dogs. Vet Surg 1992; 21: 88-98.
    CrossrefPubMedSearch in Google Scholar
  • 34 Kwong LM, O’Connor DO. A quantitative in vitro assessment of fit and screw fixation on the stability of a cementless hemispherical acetabular component. J Arthroplasty 1994; 9: 163-170.
    CrossrefPubMedSearch in Google Scholar
  • 35 Hadjari MH, Hollis JM, Hofmann OE. et al. Initial stability of porous coated acetabular implants. The effect of screw placement, screw tightness, defect type, and oversize implants. Clin Orthop Relat Res 1994; 307: 117-123.
    PubMedSearch in Google Scholar
  • 36 Perona PG, Lawrence J, Paprowski WG. et al. Acetabular micromotion as a measure of initial implant stability in primary hip arthroplasty. An in vitro comparison of different methods of initial acetabular component fixation. J Arthroplasty 1992; 7: 537-547.
    PubMedSearch in Google Scholar
  • 37 Hsu JT, Chang CH, An KN. et al. Effects of screw eccentricity on the initial stability of the acetabular cup. Int Orthop 2007; 31: 451-455.
    CrossrefPubMedSearch in Google Scholar
  • 38 Owen MR, Moores AP, Coe RJ. Management of MRSA septic arthritis in a dog using a gentamicin-impregnated collagen sponge. J Small Anim Pract 2004; 45: 609-612.
    CrossrefPubMedSearch in Google Scholar