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Acetabular reconstruction with a bipolar prosthesis and morseled bone grafts
W W Brien1, W J Bruce, E A Salvati
1Hospital for Special Surgery, New York City, N.Y. 10021.
The Journal of Bone and Joint Surgery. American Volume
|September 1, 1990
Summary
Acetabular reconstruction using morseled bone grafts and bipolar prostheses showed a high failure rate in major acetabular defects. This procedure is not recommended routinely and should be reserved for specific patient populations.
Area of Science:
- Orthopedic Surgery
- Reconstructive Surgery
Background:
- Major acetabular defects pose significant reconstructive challenges.
- Current reconstructive techniques aim to restore hip joint stability and function.
Purpose of the Study:
- To evaluate the outcomes of acetabular reconstruction using morseled bone grafts and bipolar prostheses for major acetabular defects.
- To assess the efficacy and complication rates of this specific reconstructive approach.
Main Methods:
- Retrospective evaluation of eighteen patients with major acetabular defects (13 Type-II, 5 Type-III).
- Surgical technique involved acetabular reconstruction with morseled bone grafts and bipolar prosthesis implantation.
- Minimum two-year follow-up period for all patients.
Main Results:
- High failure rate (11 out of 18 patients) within the follow-up period.
- Common failure modes included bone graft resorption, acetabular component migration, deep infection, and recurrent dislocation.
- Satisfactory clinical outcomes were observed in seven patients, but only four demonstrated radiographic evidence of bone graft incorporation.
Conclusions:
- Acetabular reconstruction with morseled bone grafts and bipolar prostheses is associated with a high failure rate.
- This technique is not recommended for routine use.
- Consideration as a salvage procedure for elderly or infirm patients as an alternative to more extensive surgeries may be warranted.