Related Experiment Video
Updated: Jun 22, 2026
The Use of Mixed Reality in Custom-Made Revision Hip Arthroplasty: A First Case Report
Published on: August 4, 2022
[Reconstruction of the acetabulum with structured bone graft in press-fit technique]
Andreas Halder1, Alexander Beier, Wolfram Neumann
1Klinik für Endoprothetik, Sana Kliniken, Sommerfeld, Germany. a.halder@sana-hu.de
Objective:
Reconstruction of defects of the superior acetabular rim with structured bone grafts in press-fit technique before total hip replacement.
Indications:
Defects of the superior acetabular rim following hip dysplasia Crowe type II-IV, avascular necrosis of the femoral head Ficat stage IV, or aseptic loosening of the cup with acetabular defects Paprosky type 2a and 2b.
Contraindications:
Acetabular defects Paprosky type 2c, 3a and 3b, septic loosening, severe osteoporosis.
Surgical Technique:
Exposure of the acetabular defect and debridement with a spherical reamer to create a concave bleeding graft bed. Shaping of the bone graft with an inverted reamer of corresponding size and oscillating saw. Press-fit insertion of the bone graft into the defect and temporary fixation with Kirschner wires. Rereaming of the acetabulum with the spherical reamer. Implantation of a cemented cup of corresponding size. Removal of Kirschner wires after setting of cement.
Postoperative Management:
Full weight bearing in case of small or medium graft, 6-week non-weight bearing in case of big load-bearing graft. Mobilization on 1st day postoperatively. Stair climbing on 7th day postoperatively. Suture removal after 10 days.
Results:
In 46 patients with 55 total hip replacements with structured grafts in press-fit technique, the Harris Hip Score improved from 38.9 points to 92.3 points after 29.4 months (12.0-84.4 months). There were two cases of delayed wound healing and one cup exchange because of aseptic loosening. Radiologically, one graft sintering by 5 mm was detected.
