Eleven- to 14-year follow-up results of cementless total hip arthroplasty using a third-generation alumina ceramic-on-ceramic bearing

To analyze long-term survivorship of cementless total hip arthroplasties (THAs) with the third-generation alumina ceramic-on-ceramic bearing, 100 consecutive THAs between 1996 and 1998 were reviewed. One cup and 2 stems were revised due to aseptic loosening. Another cup showed chipping of the acetabular liner at 8 years and required cup revision. The remaining hips showed stable bone ingrowth fixation with no osteolysis at the final follow-up. The 14-year survivorship as the end point of revision was 97.9% for the cup, 97.8% for the stem, and 95.7% for the overall implants, respectively. We conclude that cementless THA with the third-generation ceramic-on-ceramic hip bearing provided an excellent survivorship and eliminated periprosthetic osteolysis for 11 to 14 years.     

Cementless Modular Total Hip Arthroplasty in Patients Younger than Fifty with Femoral Head Osteonecrosis: Minimum Fifteen-Year Follow-Up

This study aimed to report the outcome of total hip arthroplasty (THA) with a modular femoral component in patients younger than fifty years with osteonecrosis of femoral head. Sixty-four osteonecrotic hips in fifty-five patients were available for clinical and radiographic analyses at minimum follow-up of fifteen-years. The mean Harris hip score improved from 36 points preoperatively to 92.7 points at final follow-up. Sixty-two (95.3%) hips demonstrated stable bone ingrowth. No hips showed loosening or required revision for aseptic loosening. Survivorship with an end point of stem revision for any reason was 93.8% and for aseptic loosening was 100% at 16.8 years. We believe that cementless THA with a modular stem is a promising procedure for young and active patients with osteonecrosis of the femoral head.     

Mid-term results of an uncemented tapered femoral stem and various factors affecting survivorship

ObjectiveCLS stem is commonly used today in primary hip arthroplasty, but only a few studies have evaluated their outcome in young high demanding patients. In Indian scenario, many patients require squatting and sitting cross-legged as part of their daily activities placing excessive load on the joint. We evaluated (I) Mid-long term functional and radiological results (II) Influence of age, gender, diagnosis, stem alignment, Canal fill index (CFI) on the outcome (III) Kaplan-Meier survivorship using revision for any reason or for aseptic loosening as an endpoint.MethodsRetrospective evaluation of 64 THA in 54 patients operated between July 2000 to July 2011 using CLS stem was done. Mean follow-up was 10.3 years (5–14.9 years) with 5 patients lost to follow-up and 4 patients died. Mean age at surgery was 46.8 years (18–78 years).ResultsMean Harris hip score was 89.4 (72–100). Thigh pain was present in 4 hips which were not associated with the sizing of the stem (p = .489). Stable fixation by bony ingrowth was seen in 53 hips (96.4%) and by fibrous ingrowth in 2 cases (3.6%) with no case of loosening seen. Stress shielding was seen as Grade II in 17 hips (30.9%), Grade III in 3 hips (5.4%). Pedestal formation was seen in 9 hips (16.4%) which were statistically associated with varus alignment and CFI < 80. No stem revision was performed with stem survivorship of 100%.ConclusionThe mid-term survival rates and good clinical-radiological outcomes of CLS stem in high demanding Indian population were excellent.     

Contemporary Porous Titanium Acetabular Components for Total Hip Arthroplasty After Pelvic Radiation

BackgroundPatients undergoing primary total hip arthroplasty (THA) following pelvic radiation have historically had poor survivorship free of aseptic acetabular component loosening. However, several series have reported improved results with tantalum acetabular components. The purpose of this study is to assess implant survivorship, radiographic results, and clinical outcomes of contemporary, porous titanium acetabular components in the setting of prior pelvic radiation.MethodsWe retrospectively reviewed 33 patients (38 hips) with prior pelvic radiation between 2006 and 2016 who underwent primary THA. The mean overall pelvic radiation dose was 6300 cGy with a mean latency period to THA of 5 years. The most common acetabular component was Pinnacle (DePuy Synthes) in 76%. Eight-seven percent of cups were fixed with screws. The mean age at primary THA was 74 years, 76% were male, and the mean body mass index was 30 kg/m². Mean follow-up was 5 years.ResultsThe 10-year survivorship free of revision for aseptic loosening, free of any revision, and free of any reoperation were 100%, 89%, and 89%, respectively, when accounting for death as a competing risk. There were 3 revisions; one each for taper corrosion, recurrent dislocation, and infection. Radiographically, all cups had evidence of osteointegration and none had radiographic evidence of loosening. The mean Harris Hip Score improved from 50 to 84 postoperatively (P < .0001).ConclusionContemporary porous titanium acetabular components with supplemental screws provided excellent implant fixation in patients with prior therapeutic pelvic radiation. At 10 years, 100% of these components were free of revision for aseptic loosening and 100% were radiographically well-fixed.Level of EvidenceLevel IV, Therapeutic.     

A second-generation cementless total hip arthroplasty mean 9-year results

Two hundred fifty-eight primary total hip arthroplasties in 231 patients were implanted using a circumferentially, proximally porous-coated, collared femoral component and a cementless, hemispherical, porous-coated acetabular component and followed up for a mean of 9 years (5-14 years). Four femoral components were revised (2 stems for infection and 2 stems for aseptic loosening). One additional femoral component was radiographically loose at last follow-up. Nine hips underwent acetabular revision (4 for instability, 2 for infection, 2 for loosening, and 1 for osteolysis). Ten-year survivorship with revision or loosening of any component as the end point was 92%; with femoral component aseptic loosening as end point, survivorship was 98%; with acetabular aseptic loosening as the end point, survivorship was 99%. Osteolysis was identified in 26 hips (13%).     

Long-Term Outcomes After Metal-on-Metal Total Hip Arthroplasty With a 28-mm Head: A 17- to 23-Year Follow-Up Study of a Previous Report

Background

Second-generation, metal-on-metal total hip arthroplasty (MoM THA) using a 28-mm head has shown favorable results compared with large head MoM THA. The purpose of this study is to evaluate the long-term outcomes of cementless primary MoM THA with a 28-mm head and the incidence of osteolysis using computed tomography.

Cause-Specific Stem Revision Risk in Primary Total Hip Arthroplasty Using Cemented vs Cementless Femoral Stem Fixation in a US Cohort

BackgroundWe sought to evaluate the cause-specific revision risk following hybrid (cemented stem mated to a cementless acetabular implant) vs cementless total hip arthroplasty (THA) in a US cohort.MethodsPrimary elective THA for osteoarthritis was identified using Kaiser Permanente’s Total Joint Replacement Registry (2001-2018). Multivariable Cox regression was used to evaluate cause-specific revision, including aseptic loosening, infection, instability, and periprosthetic fracture (PPF), for hybrid vs cementless THA. Analysis was stratified by age (<65, 65-74, and ≥75 years) and gender.ResultsThe study cohort comprised 88,830 THAs, including 4539 (5.1%) hybrid THAs. In stratified analysis, hybrid THA had a higher revision risk for loosening in females in all 3 age subgroups. A lower risk of revision for PPF was observed following hybrid THA in females aged ≥75 years. For females ≥75 years, cementless THA had an excess PPF risk of 0.9% while hybrid THA had an excess loosening risk of 0.2%, translating to a theoretical prevention of 10 PPF revisions but a price of 3 loosening revisions per 1000 hybrid THAs. No difference in revision risk was observed in males.ConclusionWe observed differences in cause-specific revision risks by method of stem fixation which depended upon patient age and gender. Although the trend toward all cementless fixation continue, there may be a role for hybrid fixation in females ≥75 years to mitigate risk for revision due to PPF at the potential cost of a slight increase in longer term aseptic loosening.Level of EvidenceLevel III.     

Revision Total Hip Arthroplasty Using the Modular Proximal Stem Modified for Asians: Medium-Term Clinical Results and Perioperative Complications

BackgroundThis study aimed to examine the medium-term clinical and radiological outcomes of revision THA using the S-ROM-A stem, a modification of the S-ROM stem intended for Asians.MethodsFemoral reconstruction using the S-ROM-A stem was performed in 126 hips that underwent revision THA. All patients were followed for perioperative complications. In addition, clinical and radiographic outcomes at a mean of 8 (range 5-14) years postoperatively were evaluated in 96 hips of 86 patients (76%).ResultsThe most common perioperative complication was a femoral fracture, occurring in 16 hips (13%), including 11 intraoperative and 5 postoperative fractures. Dislocation occurred in five hips (4.0%), infection in three hips (2.4%), and trunnionosis in two hips (1.6%), including late complications. The total second stem revision was performed in two hips while stem only second revision preserving the bone ingrown sleeve was performed in four hips. With a second revision for aseptic loosening as the endpoint, the 13-year stem survival rate was 100%. Hip function as assessed by the Japanese Orthopedic Association score improved from a mean of 48 points preoperatively to 87 points 8 years postoperatively (P < .05). Radiological evaluation at the final follow-up showed that 95 hips (99%) achieved bone ingrowth fixation and one hip (1%) achieved fibrous stable status.ConclusionRevision THA using the S-ROM-A stem resulted in good medium-term outcomes. Although modifications of the stem length and shape may be effective in preventing fractures in Asians with relatively small body sizes, attention should be paid to the occurrence of trunnionosis, which may be associated with the decreased taper size.     

Total Hip Arthroplasties for Hartofilakidis Type C1 and C2 High Hip Dislocations Demonstrate Similar Survivorship and Clinical Function at Minimum 10-year Follow-up With Cementless Implants

BackgroundThis study aimed to determine the differences in survivorship, clinical function, and complications among patients who have Hartofilakidis Type C1 or C2 developmental dysplasia of the hips and underwent total hip arthroplasty (THA) with cementless implants.MethodsThis retrospective study identified 84 Hartofilakidis Type C hips that underwent THA between 2002 and 2011 with a minimum 10-year follow-up (mean, 13 years, range, 10 to 19 years). Survivorship, latest Harris Hip Scores and satisfaction levels, radiographic outcomes (eg, implant stability, rate and length of subtrochanteric shortening transverse osteotomy, leg-length discrepancy, cup position, and orientation), as well as complications (eg, dislocation, periprosthetic fracture, periprosthetic joint infection) were compared to analyze the differences between Hartofilakidis C1 and C2 hips.ResultsBetween C1 and C2 hips, no difference existed in the 15-year cumulative Kaplan-Meier survivorship, with the endpoint defined as any reoperation (93.1 versus 90.8%), aseptic loosening combined with periprosthetic joint infection (93.1 versus 96.2%), or aseptic loosening (94.8 versus 96.2%), latest Harris Hip Score (87.1 versus 86.1%), vertical (6.1 versus 6.0 mm) and horizontal (11.5 versus 10.3 mm) distance to the anatomic center of rotation, postoperative leg length discrepancy (11.2 versus 15.5 mm), dislocation (5.2 versus 11.5%), stem aseptic loosening (6.9 versus 7.7%), periprosthetic fracture (3.4 versus 7.7%), and intraoperative femoral fracture (32.8 versus 23.1%). However, Type C2 hips demonstrated more severe preoperative leg length discrepancy (66.9 versus 42.5 mm) and required a higher percentage of subtrochanteric shortening transverse osteotomies (84.6 versus 36.2%) that were longer (33.7 versus 26.47 mm) than the Type C1 hips.ConclusionWith cementless cups positioned near the anatomic acetabular center and cementless stems combined with subtrochanteric shortening transverse osteotomies, THAs for the Hartofilakidis Type C1 and C2 hips demonstrated similar survivorship, clinical function, and complications.     

Minimum 10-Year Outcome of One-Stage Total Hip Arthroplasty Without Subtrochanteric Osteotomy Using a Cementless Custom Stem for Crowe III and IV Hip Dislocation

Background

Options for total hip arthroplasty (THA) in high dislocated hips include subtrochanteric osteotomy (STO), high hip center positioning, and 2-stage surgery with progressive lowering using an external fixator before THA. We described the long-term results of 1-stage THA performed without STO, using a cementless customized stem associated if necessary with sequential tenotomies and/or greater trochanteric osteotomy.

Long-Term Survival of the Cemented Exeter Universal Stem in Patients 50 Years and Younger: An Update on 130 Hips

BackgroundThere is variable evidence regarding survivorship beyond 20 years of total hip arthroplasties in young patients. We report the long-term results of the Exeter cemented hip system in patients ≤50 years at minimum of 20 years.MethodsClinical and radiological outcomes of 130 consecutive total hip arthroplasties in 107 patients aged 50 years or younger at primary operation were reviewed; 77% had a diagnosis other than osteoarthritis. All patients were followed at 5-year intervals, no patients were lost to follow-up, and the status of every implant is known.ResultsMean age at surgery was 41.8 (17-50) years. Mean follow-up was 22.0 (20.0-26.1) years. There were 79 hips surviving, 14 hips (11 patients) deceased, and 37 hips revised. Reasons for revision: 29 hips for aseptic cup loosening (26 stems revised using cement-in-cement, three left in-situ); three stems for femoral osteolysis, two related to acetabular polyethylene wear (14.1 and 17.0 years), one with Gaucher’s disease (21.1 years); one broken stem (12.9 years); one cup for instability (4.3 years–stem revised using cement-in-cement); and two hips with infection (8.5 and 23.8 years). There were no cases of aseptic loosening of the Exeter stem. There were no radiologically loose stems although eight patients had radiological evidence of loosening of the cemented cup. Survivorship at 22 years was 74.9% for revision for all causes and 96.3% for revision of the stem for aseptic loosening or lysis.ConclusionThe Exeter cemented stem has excellent survivorship at minimum 20 years in young patients. Acetabular component survivorship was less favorable, but the advent of highly cross-linked polyethylene may improve this in the long term.     

Midterm Clinical and Radiographic Outcomes of a Contemporary Monoblock Dual-Mobility Cup in Uncemented Total Hip Arthroplasty

BackgroundThe efficacy of contemporary monoblock dual-mobility (DM) cups to prevent dislocations in total hip arthroplasty (THA) is well reported, but there is little published data on their mid- to long-term outcomes. The authors aimed at reporting the 10-year survival of a contemporary DM cup as well as its clinical and radiographic outcomes.MethodsFrom a retrospective consecutive multicentric series of 516 patients (541 hips) that received uncemented THA between June 2007 and June 2010, 6 patients (6 hips) had cup and stem revisions, 5 patients (5 hips) had isolated stem revision, and 2 patients (2 hips) had isolated insert revision. A total of 103 patients (111 hips) died with their original implants, and 41 patients (42 hips) were lost to follow-up. This left 358 patients (375 hips) for clinical assessment at a median follow-up of 8.7 years (range, 6.8-10.5 years), including 279 patients (290 hips) with postoperative radiographs. Implant survival was calculated using the Kaplan-Meier method, and multivariable analyses were performed to determine whether clinical outcomes are associated with patient or surgical factors.ResultsThe 10-year survival considering revision for aseptic loosening as end point was 100% for the cup and 99.2% for the stem. No dislocations were observed, and radiographic assessment revealed 1 acetabular granuloma (0.3%), but no radiolucencies nor fractures. The Harris hip score improved from 49.6 ± 15.5 to 85.2 ± 14.5, and the postoperative Oxford hip score was 19.2 ± 7.6. Multivariable analyses revealed that improvement in Harris hip score increased with cup diameter (beta, 1.28; P = .039).ConclusionOur data confirmed satisfactory midterm outcomes of uncemented THA using a contemporary DM cup, with no dislocations nor cup revisions due to aseptic loosening.Level of EvidenceLevel IV, retrospective cohort study.     

Cementless Metasul metal-on-metal total hip arthroplasties at 13 years

Second-generation metal-on-metal bearings have been used since the late 1980s as alternative bearings to eliminate aseptic loosening due to polyethylene wear. The aim of the present study was to evaluate the long-term results of a series of Metasul (Zimmer GmbH, Winterthur, Switzerland) metal-on-metal total hip arthroplasty (THA). One hundred forty-nine cementless THAs with a 28-mm Metasul articulation were performed in 111 consecutive patients. The results were retrospectively reviewed at 13 years postoperatively. Clinical and radiographic evaluations and implant survivorship were performed. Seven hips (4.7%) were revised. The overall survivorship with revision for any reason as the end point was 0.94. The average Harris hip score was 91.4. Expansive osteolysis was found adjacent to the stem in 4 hips. Metal wear-related aseptic loosening was not the major reason for failure in our Metasul metal-on-metal THAs. Recurrent dislocation was the main reason for revision in our series.     

Revision Hip Arthroplasty Using a Modular,Cementless Femoral Stem: Long-Term Follow-Up

BackgroundAs the number of primary total hip arthroplasty (THA) cases increase, so does the demand for revision operations. However, long-term follow-up data for revision THA is lacking.MethodsA retrospective review was completed of patients who underwent revision THA at a single institution between January 2002 and October 2007 using a cementless modular stem. Patient demographic, clinical, and radiographic data was collected. Preoperative and postoperative patient-reported outcome scores were compared at a minimum of fourteen-year follow-up.ResultsEighty-four patients (89 hips) with a median age of 69 years (range, 28 to 88) at operation were included. Indications for revision included aseptic loosening (84.2%), infection (12.4%), and periprosthetic fracture (3.4%). Twenty-two hips sustained at least 1 complication: intraoperative fracture (7.9%), dislocation (6.7%), prosthetic joint infection (4.5%), deep venous thrombosis (3.4%), and late periprosthetic fracture (2.2%). There were no modular junction complications. Eight patients underwent reoperations; only three involved the stem. Thirty-eight patients (45%) were deceased prior to final follow-up without known reoperations. Twenty-seven patients (32%) were lost to follow-up. Twenty-one patients (23%) were alive at minimum fourteen-year follow-up. Complete patient-reported outcomes were available for nineteen patients (range, 14 to 18.5 years of follow-up). Significant improvement was seen in UCLA activity, VR-12 physical, hip disability and osteoarthritis outcome score, joint replacement., and Harris Hip score pain and function scores.ConclusionChallenges of long-term follow-up include patient migration, an unwillingness to travel for re-examination, medical comorbidities, advanced age, and death. The cementless modular revision stem demonstrated long-term clinical success and remains a safe and reliable option for complex revision operations.     

Lord-type uncemented total hip arthroplasty — its application to Japanese patients, long-term results and problems

Summary We investigated 270 patients (321 hips) treated by Lord-type cementless total hip arthroplasty (THA) and reported results in 234 hips that could be directly observed among 251 that were 5-year or more after operation.The mean Merle d'Aubigné and Postel hip score improved from 8.9 before operation to 15.7 at the final follow-up.However, our 20-year experience showed revision due to aseptic loosening in 27 patients. In particular, biological fixation could not be achieved in some cases treated using a screw-in ring for acetabular dysplasia or using the Fluted type stem with a smooth surface. This may be the cause of aseptic loosening, and further follow up is necessary.     

Long‐Term Clinical Outcomes and Survivorship of Total Hip Arthroplasty for Pyogenic Arthritis: A Retrospective Cohort Study of 168 Hips

ObjectiveThe aim of the present study was to evaluate the 10‐year outcomes of cementless total hip arthroplasty (THA) in adult patients with the late sequelae of septic arthritis of the hip.MethodsWe followed 166 consecutive patients (168 hips) who underwent cementless THA between March 2001 and December 2011. There were 79 men and 87 women, with a mean age of 50.4 years (range 21–76 years) at the time of index THA, all of whom had hip osteoarthritis secondary to hip pyogenic infection. The average duration of follow up was 10.6 years (range 6.9–17.2 years). Preoperative and postoperative clinical ratings were evaluated, including the hip dysfunction and osteoarthritis outcome score (HOOS), the Harris hip score (HHS), range of motion, a 100‐point visual analog scale for hip pain, and the severity of limp and limb length discrepancy (LLD). The anteroposterior and lateral radiographs of the hip and full‐length view of the lower extremities were obtained to assess the position of the components, radiolucent lines, osteolysis, loosening of components, and heterotopic ossification. The intraoperative and postoperative complications were also recorded.ResultsThe mean HSS and hip pain score were 44.2 points (range 29–66 points) and 42.5 points (range 32–64 points), respectively, before the index surgery and significantly improved to 88.1 points (range 78–96 points) and 15.1 points (range 10–26 points), respectively, at final follow‐up examination. The HOOS and range of motion also improved significantly. The mean limb length discrepancy was reduced from 2.6 to 0.8 cm. The limp at last follow‐up examination was moderate in 3 cases because of hip osteoarthritis in the other limb, slight in 26, and absent in 137. A radiolucent line was observed in 12 hips (7.1%) around the acetabular or femoral components. A progressive radiolucent line around the undersized femoral stem in all zones was seen in 1 hip, resulting in aseptic loosening and breakage of the femoral component. There were 8 cases of intraoperative fracture, 7 cases of dislocation, and 7 cases of transient nerve palsy. Recurrence of infection occurred in 2 hips. Revision surgery was conducted in 2 hips because of isolated loosening of the acetabular cup and the femoral stem, respectively. Kaplan–Meier survival was 97% at 10 years, with revision for any reason with any component as an end‐point.ConclusionImproved surgical techniques and development of components with various sizes provided favorable results for cementless THA conducted for late sequelae of sepsis in these young and active patients. Although the incidence of complications was relatively high, the complications were treated successfully.     

Medium-term result of Elite Plus hip arthroplasty: the second modular evolution of the original Charnley low-friction arthroplasty

BackgroundThe Elite Plus total hip arthroplasty (THA) system was introduced as the second modular evolution of the original Charnley low-friction arthroplasty. However, the results of the Elite Plus THA are currently considered to be inconsistent. The aim of this study was to clarify the medium-term results and the factors affecting the results of Elite Plus THA.MethodsThe results of 97 Elite Plus THAs in 87 patients at 5 years or more postoperatively were reviewed. The patients’ mean age was 65 years, and follow-up averaged 8.0 years. The Elite Plus stem was used in all hips, and three designs of socket, Hylamer Ogee in 40 hips, Wroblewski Offset Bore in 38, and Charnley Ogee in 19, were implanted. The survival rates with loosening and revision as endpoints were analyzed. To clarify the risk factors affecting the survival rates, Charnley’s functional classification, Bombelli’s classification, Crowe’s classification, structural bone grafting of the acetabulum, cup design, stem position, and grading of the cement mantle were evaluated.ResultsThe stem survival rate with aseptic loosening as the endpoint was 96 %, and the rate with revision was 100 %. The cup survival rate with aseptic loosening as the endpoint was 80 %, and the rate with revision was 93 %. Using a Cox proportional hazards model, cup design was a potential confounding factor for acetabular loosening (p = 0.001). The loosening rates were 31 % for Hylamer Ogee sockets at 9.4 years, 8 % for Wroblewski Offset Bore sockets at 7.4 years, and 0 % for Charnley Ogee sockets at 5.6 years. No factors were significantly related to acetabular revision and femoral loosening.ConclusionsThe results of Elite Plus stem THA were excellent in the medium term. The cup design was a potential confounding factor for acetabular loosening, and the Hylamer Ogee socket was associated with a poor result.     

Cementless acetabular fixation in patients 50 years and younger at 10 to 18 years of follow-up

The purpose of the study was to evaluate the 10- to 18-year follow-up of cementless acetabular fixation in patients 50 years and younger. We retrospectively reviewed a consecutive group of 118 patients (144 hips) in whom primary total hip arthroplasty had been performed by 2 surgeons using a cementless acetabular component. Two (1.4%) cementless acetabular components were revised because of aseptic loosening. Twenty-four hips (16.7%) were revised for any mechanical failure of the acetabular component mostly related to acetabular liner wear and osteolysis. The average linear wear rate was 0.19 mm per year, which was higher than our previous reports with cemented acetabular fixation. The fiber mesh ingrowth surface of the cementless acetabular component in this study was superior to cemented acetabular components in terms of fixation. However, the high rates of wear and osteolysis have led to poor overall acetabular component construct survivorship.     

Clinical and Radiological Outcome of Acetabular Reconstruction Rings in Complex Primary and Revision Total Hip Arthroplasty

BackgroundAcetabular reconstruction in complex primary and revision total hip arthroplasty (THA) with bone loss poses a great challenge. We aim to evaluate the medium-term clinical and radiological outcome of reconstruction rings used in these difficult situations. MethodsWe retrospectively reviewed a consecutive series of acetabular reconstructions with Muller ring or Bursh-Schneider cage from January 2009 to December 2016. The reconstruction rings were used in 66 hips (65 patients). There were 41 complex primary THA and 25 revision THA. The mean follow-up period was 76 months (range, 37–167 months). Clinical evaluation includes the assessment of Harris hip score, visual analogue scale (VAS) score, limb length discrepancy, and activities of daily living. The radiographs were analyzed for any signs of loosening, osteolysis, acetabular migration, and heterotopic ossification.ResultsThe overall survival rate was 95% for revision in aseptic loosening and 87% for any reason at an average follow-up of 6.3 years. Twelve patients died and 9 patients were lost to follow-up leaving 45 patients for final functional analysis. Among the 45 patients, excellent to good results were seen in 33 patients, fair results were seen in 5 patients, poor results were seen in seven patients. Two patients had aseptic loosening and another two patients developed deep chronic infection awaiting two-stage revision.ConclusionReconstruction rings still place a role in the armamentarium for complex acetabular reconstruction. It helps to reliably restore the bone stock, have an acceptable survival rate and satisfactory functional outcome at medium to long-term follow-up.