Inverted reamer technique for bone grafting of the acetabulum: technical note

Bone grafting in acetabular reconstruction remains a challenge, particularly in patients with dysplastic hips. Current techniques often struggle to achieve adequate socket coverage, which can lead to poor long-term outcomes. Prior research has shown that insufficient graft compatibility may compromise implant stability and function. However, no prior work had resolved the issue of graft shaping in cemented total hip arthroplasty (cTHA). This gap motivated the development of a new method to improve graft fit and coverage. The need for a simplified grafting approach is especially relevant for surgeons with limited experience. Existing literature suggests that graft misfit can increase the risk of implant loosening. No prior work had demonstrated a technique that uses reamed femoral head material to create a graft. This study addresses that limitation by introducing a novel approach.

The study aimed to introduce a simplified grafting method for acetabular reconstruction in cTHA. The specific problem addressed is the difficulty of achieving graft compatibility in dysplastic hips. The motivation stems from the technical challenges faced by surgeons, particularly trainees. The goal was to develop a method that is easy to perform and reliable. The approach focuses on using reamed femoral head material to create a graft. The study sought to demonstrate that this method improves graft fit and coverage. The method was designed to be accessible to all surgeons, regardless of experience. The authors propose that this technique enhances outcomes in cTHA for dysplastic hips.

The inverted reamer technique involves preparing a bone graft from the resected femoral head. The reamer is inverted to shape the graft to match the acetabular defect. After standard acetabular preparation, the graft is created using this modified reamer. The graft is then press-fit into the defect with minimal adjustment. Fixation is achieved using 1–3 screws to secure the graft in place. The acetabular socket is implanted using bone cement after graft placement. The method relies on the reamer’s geometry to ensure graft compatibility. The technique is designed to be performed with standard surgical tools and minimal training.

The inverted reamer technique successfully created a graft that fit the acetabular defect with high compatibility. The graft was press-fit into the defect without requiring additional shaping. Fixation with 1–3 screws provided stable graft placement. The socket was implanted in the anatomic position using bone cement. The method was found to be simple and technically less demanding. Surgeons with limited experience could perform the technique reliably. The graft preserved bone stock and increased socket coverage. The authors suggest this method improves outcomes in cTHA for dysplastic hips.

The inverted reamer technique offers a simple and reliable method for bone grafting in cTHA. The authors propose that this method improves graft fit and coverage in dysplastic hips. The technique is technically less demanding and accessible to all surgeons. The method preserves bone stock and enhances socket coverage. The graft is shaped automatically using the reamer, reducing preparation time. The authors suggest this approach improves outcomes in cTHA. The technique is suitable for trainees and inexperienced surgeons. The authors propose that this method enhances implant stability and function.