The value of bulk femoral head allograft in acetabular reconstruction using Kerboull-type plate

This study investigated the mid- and long-term results of acetabular reconstruction using a KT plate with an allograft and showed the utility of filling the bony defect with bulk femoral head allograft rather than morselised allograft.

We retrospectively investigated a consecutive series of 31 hips in 30 patients who underwent primary THA or revision THA between March 2002 and March 2012. Bulk grafts from femoral head allografts were used in 16 hips and morselised grafts were used in 15 hips. The mean follow-up period was 7.2 years (3-13 years). The acetabular bone defects were classified according to the American Academy of Orthopedic Surgeons grading system. Type II defects were present in five hips; 26 hips were type III.

Radiological failure, defined as absolute error of the inclination of the KT plate >3°, breakage of the KT plate or screw, and/or absolute error of the vertical or horizontal migration of the femoral head >3 mm was found in 12 cases. All these complications appeared in the morselized group; there were no complications in the bulk group. The eight-year survival rate of morselised grafts was 52.5% and that of bulk grafts was 100%, using radiological loosening as an end point.

We conclude that using bulk graft from femoral head allografts is necessary to achieve mechanically stable reconstruction for large acetabular bone defects.