J Korean Hip Soc.  2007 Dec;19(4):479-486. 10.5371/jkhs.2007.19.4.479.

Acetabular Reconstruction with Impacted Morselized Allograft, Wire Mesh and Cemented Acetabular Cup in Severe Acetabular Bone Defect

Affiliations
  • 1Department of Orthopedic Surgery, School of Medicine, Kyung Hee University, Seoul, Korea. yjcho@khmc.or.kr

Abstract

PURPOSE
This study evaluated the clinical and radiographic results of an acetabular reconstruction with an impacted morselized allograft and wire mesh in revision total hip arthroplasty.
MATERIALS AND METHODS
This study examined 21 cases of acetabular revisions involving 20 patients with a severe acetabular bone defect managed with an impacted morselized allograft, wire mesh and cemented acetabular cup between February 2000 and June 2003. The mean follow up period was 31.7 months. Clinically, the Harris hip score was evaluated. The radiographic parameters included bony incorporation between the host bone and allograft, the change in cup inclination, acetabular cup migration, radiolucency around the cup and loosening.
RESULTS
The mean Harris hip score was improved from a preoperative 54.1 to 91.9 at the last follow up. Radiological incorporation between the host bone and allograft was achieved after an average 11.4 months after surgery. The mean change in cup inclination was 1.9 degrees, and the mean medial and superior migration was 3.93 mm and 4.41 mm respectively. The majority of these radiological changes occurred within 6 months after surgery. One case of Brooker grade I heterotopic ossification and one case of acetabular cup loosening was observed but there was no re-revision or complications, such as infection and dislocation.
CONCLUSION
In a severe acetabular bone stock deficiency that cannot be reconstructed with a cementless acetabular cup, an acetabular reconstruction with an impacted morselized allograft, wire mesh and cemented acetabular cup showed good results in this short term follow up study.

Keyword

Acetabular bone defect; Revision total hip arthroplasty; Impacted morselized allograft; Wire mesh; Cemented acetabular cup

MeSH Terms

Acetabulum*
Allografts*
Arthroplasty, Replacement, Hip
Dislocations
Follow-Up Studies
Hip
Humans
Ossification, Heterotopic
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