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[Revision of failed acetabular cups with extensive structural allografts]
G Saxler1, J G Fitzek, T Sterner
1Klinik und Poliklinik für Orthopädie, Universität Duisburg-Essen, Essen.
Zeitschrift Fur Orthopadie Und Ihre Grenzgebiete
|March 9, 2005
Summary
Structural allografts show promising results for acetabular reconstruction in revision hip arthroplasty. While osseointegration is successful in most cases, careful consideration of cementless cup use is advised.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Bone Reconstruction
Background:
- Structural allografts are utilized for complex orthopedic reconstructions, including revision total hip arthroplasty (THA) and bone tumor resections.
- Acetabular defects in revision THA present significant challenges requiring robust bone stock restoration.
Purpose of the Study:
- To evaluate the clinical and radiological outcomes of structural allografts in acetabular revision surgery.
- To assess the efficacy and complication rates associated with allograft use in challenging hip arthroplasty revisions.
Main Methods:
- Fifteen patients with Paprosky type 3A or 3B acetabular defects underwent revision THA using structural allografts (femur, tibia, acetabulum).
- Grafts were fixed with AO screws, and various acetabular components (cemented, cementless) were implanted.
- Mean follow-up was 7.9 years.
Main Results:
- Successful osseointegration was achieved in 13 out of 15 allografts.
- Two allografts failed due to aseptic loosening and deep infection.
- One cementless cup migrated, necessitating revision with a cemented ring. Mean Harris Hip Score was 81.4.
Conclusions:
- Structural allografts are recommended for acetabular bone stock reconstruction and anatomical restoration in revision THA.
- The combination of cementless cups with structural allografts requires critical evaluation due to potential complications.