{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T19:02:51Z","timestamp":1789844571485,"version":"4.0.1"},"reference-count":36,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"vor","delay-in-days":35,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J. exp. orthop."],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The combined use of reconstruction rings and modular trabecular metal (TM) augments can be a viable individual treatment in selected patients with large severe acetabular bone defects. However, clinical data on the outcome of this surgical technique is limited. This study aimed to evaluate mid\u2010term results of reconstruction rings used in combination with modular TM augments for severe acetabular defects in revision hip arthroplasty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed 23 patients with Paprosky type III A or B acetabular defects who underwent revision surgery using a reconstruction ring with a cemented cup in combination with a modular TM augment. 16 patients had type III A defects and 7 patients suffered from type III B defects. Clinical outcome was assessed using patient\u2010reported outcome scores (PROMs). CT scans were used to assess preoperative bone loss and plain radiographs were used to determine postoperative implant migration. Blood tantalum concentrations were measured at latest follow\u2010up and compared to a control group of patients without metal implants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      18 patients could be contacted. 9 patients underwent a complete clinical and radiological follow\u2010up examination as well as a blood test. The cumulative survival rate at 7.4 years with the endpoint \u2018acetabular component revision for any reason\u2019 was 86.7% (95% confidence interval 56%\u201396%). At the most recent follow\u2010up two patients (9%) had undergone revision surgery due to aseptic loosening of the acetabular construct. Three patients showed radiological signs of loosening of the reconstruction ring without clinical symptoms. The PROMs improved significantly to the latest follow\u2010up. Blood tantalum concentrations were elevated in the study group (0.06\u2009\u00b5g\/L) compared to controls (0.002\u2009\u00b5g\/L) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this study, favourable mid\u2010term (mean 7.4 years) clinical and radiological outcomes of modular TM augments in combination with a reinforcement ring and cemented revision cups for individual reconstructing major acetabular defects were observed. Aseptic loosening is the main reason for revision, whereby the TM augment was firmly osseointegrated in all cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV, retrospective case series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jeo2.70489","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T16:16:10Z","timestamp":1762359370000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mid\u2010term results of reconstruction rings used in combination with modular tantalum augments for Paprosky type III acetabular defects in revision hip arthroplasty"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3072-5390","authenticated-orcid":false,"given":"David","family":"Spranz","sequence":"first","affiliation":[{"name":"Department of Orthopaedics Heidelberg University Hospital Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa\u2010Marie","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Heidelberg University Hospital Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3687-9830","authenticated-orcid":false,"given":"Raphael","family":"Trefzer","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Heidelberg University Hospital Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pit","family":"Hetto","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Heidelberg University Hospital Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timo","family":"Nees","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Heidelberg University Hospital Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tilman","family":"Walker","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Heidelberg University Hospital Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4563-6718","authenticated-orcid":false,"given":"Tobias","family":"Reiner","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Heidelberg University Hospital Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,5]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcot.2019.04.021"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/ma13071783"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12011-024-04278-2"},{"key":"e_1_2_12_5_1","first-page":"135","article-title":"[Reconstruction by graft and reinforcement device in severe aseptic acetabular loosening: 10 years survivorship analysis]","volume":"87","author":"Bonnomet F","year":"2001","journal-title":"Revue de chirurgie orthopedique et reparatrice de l\u2032appareil 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