Bone impaction grafting and a cemented cup after acetabular fracture at 3-18 years

The outcome of total hip arthroplasty after acetabular fracture is compromised. We studied if the bone impaction grafting technique could provide long-term prosthesis survival in deformed and irregular acetabula. We studied 20 hips in 20 patients (mean age, 53.3 years; range, 35-75 years) that were reconstructed with acetabular bone impaction grafting and a cemented total hip prosthesis after acetabular fracture. No patient was lost to followup. At review the mean followup was 9.5 years (range, 3-18 years) and the average Harris hip score was 93 (range, 62-100). During followup there were two cup revisions: one after 14.5 years for septic loosening, and one after 15.3 years for aseptic loosening. The Kaplan-Meier survival rate of the cup with end-point revision for any reason was 100% at 10 years and 80% (95% CI; range, 62-98%) after 15 years. With end-point cup revision for aseptic loosening the survival rate was 100% at 10 years. Acetabular bone impaction grafting with a cemented cup is a biologically attractive technique with good long-term survival used to reconstruct bone stock loss after posttraumatic arthritis. The complication and reoperation rate was low in this relatively young group of patients.

Therapeutic study, Level IV (Case series--no, or historical control group). See the Guidelines for Authors for a complete description of levels of evidence.