Mid-term follow-up after all-size acetabular revision and proposal for a stability classification system

Abstract

Background: There is a trend for using jumbo cups/oblong devices for acetabular reconstruction as alternative to biological solutions. We report about a spectrum of reconstruction methods and their mid-term results. Methods: Inclusion of 214 consecutive patients undergoing total hip arthroplasty revision surgery. Patients were examined using the Harris Hip Score (HHS). Based on the intraoperative acetabular defect situation, cases were classified into 1 of 5 possible categories of a stability classification for acetabular replacement (SCAR). Results: Mean HHS improved from 42 preoperatively (range 12–62) to 77 (range 54–90; p < 0.05) 6 months after operation. There were significant differences of the pre-and postoperative HHS between SCAR subgroups ( p < 0.05). Inter-observer reliability of the SCAR was high (kappa 0.94 (95% CI, 0.90–0.98)). Re-revision was performed in 15 cases (7%). Conclusion: The SCAR classification is a practicable tool for intraoperative decision-making as it provides standardised treatment recommendations.