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  • Title: Excellent long-term results of the Müller acetabular reinforcement ring in primary total hip arthroplasty: A prospective study on radiology and survival of 321 hips with a mean follow-up of 11 years.
    Author: Sirka A, Clauss M, Tarasevicius S, Wingstrand H, Stucinskas J, Robertsson O, Ochsner PE, Ilchmann T.
    Journal: Acta Orthop; 2016; 87(2):100-5. PubMed ID: 26471881.
    Abstract:
    BACKGROUND AND PURPOSE: The original Müller acetabular reinforcement ring (ARR) shows favorable medium-term results for acetabular reconstruction in total hip arthroplasty, where it is used when the acetabular bone stock is deficient. However, there are no data regarding long-term survival of the device. We therefore investigated long-term survival and analyzed radiological modes of failure. PATIENTS AND METHODS: Between 1984 and 2002, 321 consecutive primary arthroplasties using an ARR were performed in 291 patients. The mean follow-up time was 11 (0-25) years, and 24 hips were lost to follow-up. For survival analysis, we investigated 321 hips and the end of the follow-up was the date of revision, date of death, or the last patient contact date with implant still in situ. Radiological assessment was performed for 160 hips with a minimum of 10 years of follow-up and with radiographs of sufficient quality. It included evaluation of osteolysis, migration, and loosening. RESULTS: 12 ARR THAs were revised: 1 isolated ARR revision for aseptic loosening, 4 revisions of the ARR and the stem for aseptic loosening, 6 for infection, and 1 for recurrent dislocation. The cumulative revision rate for all components, for any reason, at 20 years was 15% (95% CI: 10-22), while for the ARR only it was 7% (95% CI: 4-12) for any reason and 3.4% (95% CI: 1-9) for aseptic loosening. 21 (13%) of 160 ARR THAs examined had radiological changes: 7 had osteolysis but were not loose, and 14 were radiologically loose but were not painful and not revised. INTERPRETATION: Our data suggest that the long-term survival of the ARR is excellent.
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