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The Exeter method-acetabular impaction grafting with cemented reimplantation.

T G Petheram1, J R Howell

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Summary

This study demonstrates a successful acetabular revision surgery technique using bone impaction grafting. The method restores hip anatomy and biomechanics, achieving up to 87% survival at 20 years for aseptic loosening.

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Area of Science:

  • Orthopedic surgery
  • Bone grafting techniques
  • Revision hip arthroplasty

Background:

  • Revision hip surgery often requires addressing acetabular bone defects.
  • Osteolysis, infection, and trauma can lead to significant acetabular bone loss.
  • Restoring bone stock is crucial for implant stability and long-term success.

Purpose of the Study:

  • To describe and evaluate a technique for acetabular reconstruction using impaction grafting.
  • To restore acetabular anatomy and biomechanics in revision hip arthroplasty.
  • To assess the long-term outcomes of this bone grafting method.

Main Methods:

  • Acetabular exposure and defect preparation.
  • Containment of defects using mesh or augments.
  • Impaction grafting with allograft or autograft bone chips.
  • Cementation of a polyethylene acetabular component.

Main Results:

  • The described technique is successful and reproducible.
  • Achieved up to 87% survival at 20 years for aseptic loosening in the revision setting.
  • Demonstrates effective restoration of acetabular bone stock.

Conclusions:

  • Impaction grafting is a viable method for acetabular reconstruction in revision hip surgery.
  • This technique offers a durable solution for significant acetabular bone defects.
  • It successfully restores hip biomechanics and improves implant survival rates.