Acetabular Revision Total Hip Arthroplasty Using Uncemented Cup and Morselized Impacted Allograft

Lee, Joong Myung; Kim, Jeong Min; Kim, Sung Dug

Abstract

PURPOSE: This study was undertaken to evaluate the clinical and radiographic results of acetabular revision arthroplasty using an uncemented big cup and a morselized impacted allograft.
MATERIALS AND METHODS
This study involved 81 hips of 77 patients experienced over a 2 year period (2-8 years 10 months). The bone defects of the acetabulum were classified by AAOS classification and by the Paprosky classification. We inserted an uncemented hemispherical cup by press-fitting technique as large size as possible. Only morselized impacted allograft was used for the bone defect.
RESULTS
The average Harris hip score was 95.9. One case (Paprosky type IIIB) received revision with only morselized allograft and failed to achieve initial stability. Therefore re-revision was performed with tricortical autograft and morselized allograft which has been well maintained until now for 3.5 years. Vertical migration and horizontal migration of more than 3 mm were noted in five cases and two cases, respectively. Rotational migration of more than 8 degree was not noted. A radiolucent line between bone and cup was seen in 9 cases, and a radiolucent line between host bone and grafted bone in 2 cases, this line was less than 2 mm large.
CONCLUSION
We believe this method is a good option in revision acetabular total hip arthroplasty.