Acetabular de-escalation in hip revision

Acetabular de-escalation in hip revision


  • Fabrizio Rivera Orthopedics and Trauma Department, SS Annunziata Hospital, Savigliano (CN), Italy
  • Alessandro Bardelli Orthopedics and Trauma Department, SS Annunziata Hospital, Savigliano (CN), Italy
  • Pietro Maniscalco 2Orthopedics and Traumatology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
  • Andrea Giolitti Orthopeadics and Traumatology Department, University of Turin, Torino, Italy


hip revision, de-escalation technique, Burch Schneider cage


Background: The idea of ‘‘de-escalation’’ (DE) indicates an arthroplasty revision performed by changing a revision component by a primary component. Aim of this study is to verify if this technique can represent an option in case of cage or ring failure. Methods: We observed five cases of revision hip cage loosening with complete allograft consolidation. This group of patients were revised with use of a primary cup and were specifically followed in ours institutions offices. Patients were clinically and radiologically followed every 6 months for the next two years and then annually Results: At final follow-up (15-2 years, mean 6 years) four patients (80%) showed a good recovery of their levels of activity. The mean Harris hip score improved from 20 points (range,7-38 points) preoperatively to 48 points (range, 16-88 points). At final radiological follow-up acetabular components were radiographically stable at the last follow-up. One patient (20%) at two years follow-up, was unable to walk without crutchies due to hip pain. X-rays showed cup loosening in all three zones. Patient was dissatisfied. Primary cup was revised with a Burch Schneider cage. Conclusions: De-escalation technique is a surgical option to consider in case of young patients, limited number of previous revisions and more than three years survivorship of loosened acetabular cage.

Author Biography

Fabrizio Rivera, Orthopedics and Trauma Department, SS Annunziata Hospital, Savigliano (CN), Italy

Corrisponding Author

Fabrizio Rivera, MD

Via Servais 200a/16, 10146, Torino, Italia

Tel 3472992578

[email protected]


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How to Cite

Acetabular de-escalation in hip revision. Acta Biomed [Internet]. 2020 May 30 [cited 2024 Jun. 24];91(4-S):110-4. Available from: