Use of structural allografts in acetabular revision surgery

Bone loss is a challenging problem with complex acetabular revisions. With an adequate biologic and mechanical environment, uncemented hemispheric component reconstructions have provided long-term durable results for acetabular revisions. Decisions about reconstructive options can be made with the aid of a classification system that addresses the location and severity of bone loss as it relates to achieving the prerequisites for biologic fixation with a hemispheric component. Structural allograft may be used to provide a mechanical environment that supports host bone ingrowth into an acetabular component. Alternatively, structural allograft may allow restoration of joint mechanics in situations where host bone loss precluded biologic fixation. We describe the indications and technique for the use of structural allograft in revision acetabular surgery.