Uncemented sockets:
A technique that has gained increasing popularity in the last 7-10 years is
the use of metal components without cement for revision of the acetabulum. These
shells are very much like those used in primary surgery but have addtional holes
provided so as to allow maximum flexibility to the surgeon is inserting supplemental
screws. This is particularly useful where the bone is weak and the interference
fit of the metal socket and bone, relatively poor.
More recently, these implants are being coated with hydroxyappatite which appears to promote the growth of bone onto the special surface of the metal shell. In some of the more complex cases with assymetric or unusal patterns of bone loss, the shells are available with modular "add ons" of different sizes that can be fixed to the shell to match the individual patient's bone deficiency. This means that the surgeon is not limited to simply implanting larger and larger hemispherical metal shells to make up a deficiency that exists only in one sector of the socket.
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