Acetabular revision arthroplasty: using the Hastings bipolar head to enable retention of a well-fixed monoblock stem.

Abstract

We describe a novel technique of combining the Hastings bipolar head, matched in size to the acetabular cup liner, with a fixed, cemented monoblock stem allowing for isolated uncemented acetabular revision arthroplasty. To assess patient clinical and radiological outcomes after isolated uncemented acetabular revision arthroplasty using the Hastings bipolar head. Clinical outcome was assessed with the Oxford and WOMAC hip scores.
Radiographs were assessed preoperatively for acetabular defects. Post operative osseointegration of the acetabular cup was then classified and the femoral stem was examined for signs of loosening. Nine acetabular components were revised in eight patients. Preoperative acetabular defects ranged from Paprosky type 1 to 3A. There were no significant intra or postoperative complications. At a mean final follow-up of 15 months, the Oxford hip score improved from an average of 17.5 preoperatively to 44.1, and the WOMAC score had improved from 44.1 to 90.9. Eight acetabular cups demonstrated three or more signs of osseointegration with the remaining cup showing two signs. There were no signs of loosening of the retained femoral stems. These short term results of the use of the Hastings bipolar head in isolated uncemented acetabular revision arthroplasty demonstrate good patient outcomes, reduced morbidity, decreased technical difficulties for the surgeon and reduced expense for the health service.