[Acetabular revision by using uncemented cup and impacted morselized allografts]

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Regenerative Medicine

Background:

• Acetabular revision surgery addresses bone loss and implant failure in total hip arthroplasty.
• Uncemented implants offer biological fixation but pose challenges in cases of significant acetabular defects.
• Deep frozen morselized allografts provide osteoconductive and osteoinductive potential for bone reconstruction.

Purpose of the Study:

• To evaluate the medium-term efficacy of using impacted deep frozen morselized allografts in uncemented acetabular revision.
• To assess the restoration of bone stock, hip center, and implant stability.
• To analyze clinical and radiographic outcomes in patients undergoing this revision technique.

Main Methods:

• A cohort of 58 patients (62 hips) underwent acetabular revision using impacted deep frozen morselized allografts and uncemented cups with screw fixation.
• Defects were filled with impacted allograft material, followed by implant insertion.
• Patients were assessed clinically (Harris score) and radiographically, with follow-up ranging from 6 to 13 years.

Main Results:

• Significant improvement in Harris scores (61.1 to 92.0, P < 0.05) was observed.
• Excellent or good results were achieved in 90.3% of hips.
• The 8-year Kaplan-Meier survival rate for the cup was 94.2%, with low rates of osteolysis and heterotopic ossification.

Conclusions:

• The combination of uncemented cups and deep frozen morselized allografts is a reliable method for acetabular revision.
• This technique effectively restores bone stock, hip center, and provides stable fixation.
• Favorable medium-term clinical and radiographic results support its use in complex acetabular reconstructions.