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Introduction <p>Two-stage revision of total hip arthroplasty (THA) remains the gold standard for periprosthetic joint infection (PJI). Trabecular Metal (TM) offers a valuable option for acetabular reconstruction, but evidence in septic revision THA (rTHA) is scarce. This study evaluated outcomes of TM implants in two-stage rTHA for infection, hypothesizing results comparable to existing literature, especially in cases with major bone loss.</p> Materials and method <p>We retrospectively analyzed 32 two-stage rTHA (32 patients) performed between January 2010 and July 2021, with a minimum two years follow-up. All patients received TM acetabular implants. Bone loss was classified according to Paprosky: 3 IIA, 8 IIB, 3 IIC, 12 IIIA, and 6 IIIB, with pelvic discontinuity in 13 cases.</p> Results <p>At mean follow-up of 30.2 ± 10.9 months (range, 24 to 69), infection eradication was achieved in 87,5%. Staphylococcus species accounted for 84,4% of cases. Seven complications occurred, including six reoperations: five revisions (two for recurrent infection, 3 for mechanical failure). The overall failure rate was 21,9%. At 24 months, the healing rate, including all causes of failure, was 78,1% and revision-free rate 84,4%.</p> Conclusion <p>TM implants in two-stage rTHA for septic failure achieved satisfactory mid-term results, even in advanced acetabular bone loss (44% Paprosky II, 56% Paprosky III). To our knowledge, this is the first study exclusively evaluating TM in this context, supporting its role in complex acetabular reconstruction during septic revisions.</p> Level of evidence <p>IV</p>

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Results of trabecular metal acetabular reconstruction in two-stage revision of infected total hip arthroplasty with large bone defect

  • 期刊论文

  • 发表日期：

    2025年10月31日

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  • Thomas Nicolaï,
  • Matthieu Ollivier,
  • Jean-Noël Argenson,
  • Xavier Flecher,
  • Marie Le Baron

摘要

Introduction

Two-stage revision of total hip arthroplasty (THA) remains the gold standard for periprosthetic joint infection (PJI). Trabecular Metal (TM) offers a valuable option for acetabular reconstruction, but evidence in septic revision THA (rTHA) is scarce. This study evaluated outcomes of TM implants in two-stage rTHA for infection, hypothesizing results comparable to existing literature, especially in cases with major bone loss.

Materials and method

We retrospectively analyzed 32 two-stage rTHA (32 patients) performed between January 2010 and July 2021, with a minimum two years follow-up. All patients received TM acetabular implants. Bone loss was classified according to Paprosky: 3 IIA, 8 IIB, 3 IIC, 12 IIIA, and 6 IIIB, with pelvic discontinuity in 13 cases.

Results

At mean follow-up of 30.2 ± 10.9 months (range, 24 to 69), infection eradication was achieved in 87,5%. Staphylococcus species accounted for 84,4% of cases. Seven complications occurred, including six reoperations: five revisions (two for recurrent infection, 3 for mechanical failure). The overall failure rate was 21,9%. At 24 months, the healing rate, including all causes of failure, was 78,1% and revision-free rate 84,4%.

Conclusion

TM implants in two-stage rTHA for septic failure achieved satisfactory mid-term results, even in advanced acetabular bone loss (44% Paprosky II, 56% Paprosky III). To our knowledge, this is the first study exclusively evaluating TM in this context, supporting its role in complex acetabular reconstruction during septic revisions.

Level of evidence

IV