Treatment of large acetabular defects: a surgical technique utilizing impaction grafting into a metallic mesh
Johannes Buckup1, Emiliano Alvarez Salinas2, Alejandro Gonzalez Della Valle1
1Adult Reconstruction & Joint Replacement Division, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.
Background:
Revision total hip arthroplasty in cases with severe acetabular bone loss is challenging. In the presence of combined cavitary and segmental defects without superior acetabular coverage, reconstructions with a structural acetabular allograft protected by a cage or a custom-made triflange cage have been the treatment of choice. The current paper describes an impaction grafting into a mesh for uncontained defects in revision total hip arthroplasty.
Description Of Technique:
After restoring containment with a mesh fixed with small fragment screws, defects were restored using impaction grafting combined with a cemented all-polyethylene cup.
Patients And Methods:
Fourteen consecutive acetabular impaction graftings were performed by two surgeons. All patients had a type 3B defect according to the Paprosky classification.
Results:
No re-revisions or radiographic failure was detected in the early follow-up period.
Conclusion:
Impaction grafting into a mesh is an interesting treatment option to restore bone in combined cavitary and segmental defects.
