Outcome of Patients Treated With Porous Tantalum Acetabular Implants for Neoplastic Periacetabular Lesions

Matthew T. Houdek, Matthew P. Abdel, Kevin I. Perry, Ahmet Salduz, Peter S. Rose, Franklin H. Sim, David G. Lewallen

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Abstract

INTRODUCTION: The periacetabular region is a common location for nonprimary neoplastic tumors. Although these tumors were historically treated with a cemented acetabular implant, we previously reported on the short-term follow-up on the use of a tantalum acetabular shell to reconstruct these defects. This study expands our previous report on longer follow-up, with specific emphasis on patient and implant survivorship, radiographic results, and clinical outcomes. METHODS: Fifty-eight patients (32 women and 26 men) were treated using a tantalum acetabular implant and total hip arthroplasty to reconstruct a nonprimary neoplastic process between 2001 and 2014. The mean age and body mass index were 62 years and 28 kg/m, respectively. The most common diagnosis was metastatic disease (n = 29). The patients' medical records and radiographs were reviewed to assess Harris hip scores and radiographic fixation. The mean follow-up for surviving patients was 8 years. RESULTS: At the most recent follow-up, 41 patients were dead of the disease and 17 were alive with the disease and no cases of acetabular implant revision were reported. Two patients had a progressive radiolucent line; however, they also had radiographic evidence of local disease progression. After reconstruction, patients had a significant (P = 0.0001) increase in their Harris hip score (37 vs. 72). DISCUSSION: In patients with periacetabular metastatic diseases and hematologic malignancies treated with total hip arthroplasty, a highly porous tantalum revision-type shell fixed with multiple screws, and supplemental support with acetabular augments or cup-cage reinforcement, can successfully provide patients with a stable, well-fixed, and durable construct, with no cases of mechanical failure at mid-term follow-up.

Original languageEnglish (US)
Pages (from-to)256-262
Number of pages7
JournalThe Journal of the American Academy of Orthopaedic Surgeons
Volume28
Issue number6
DOIs
StatePublished - Mar 15 2020

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ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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