Revision Arthroplasty in Acetabular Defect

Kim, Young Min; Lee, Kwan Hee; Roe, Sang Gweon

Abstract

It has been established that total hip replacement arthoplasty is one of the most excellent treatment modalities of adult hip joint disease. But aseptic loosening of the acetabular component is a main cause of revision and acetabular defects must be supported to engage the acetabular cup. Many authors have been managed this problem with the various methods of using acetabular ring, bone cement, autogenous or allogeoous bone graft and bipolar endoprosthesis. As the time goes on, it is inevitable that the numbers of revision arthroplasty cases will increase. We observed 36 patients, 39 cases of revision arthroplasty from 1981 and analysed the cases. 27 cases were treated by autogenous lilac block bone to support the acetabular defects. Complete or incomplete iliac block bone was grafted to superior, medial and posterior aspect of acetabulum. Some screws were inserted when they are needed for bone graft fixation. Hip spica casts were applied in 24 cases for 2 or 3 months and crutches were used for about 3 months. Pre-and postoperative hip joint functions by Harris score was increased form average 58.2 to 81.3(23.1 points increment). Sixteen cases were followed up for more than one year and all the bone grafts were united well without bone resorption. We found that autogenous iliac block bone can support the acetabular defects satisfactorily in revision arthroplasty cases.