[Acetabular reconstructions using spongious grafts in reoperation of total hip arthroplasties]

Loosening of acetabular cups in cemented total hip arthroplasties is associated with an important bone destruction. Within all the solutions proposed, the authors relate their experience of 46 cases treated by cancellous morcelised bone grafts to reconstruct the bone stock, in order to position correctly the new socket and provide a better cemented fixation. With a mean follow-up of 32 months, the clinical and radiological results were good with 2 loosenings, 1 due to a septic recurrence. The evolution of allografts and autografts were similar. This technique is specially adapted to the cavitary bone lesions but is also suitable to treat some segmentary lesions. It was associated to a metallic support in cases of fractures or severe bone lesions. This technique seems to be superior to a new isolated cementation, to the utilisation of acetabular mobile sockets or to structural massive bone grafts.