Two-stage Acetabular Impaction Bone Grafting: A Case Report

Area of Science:

• Orthopedic Surgery
• Biomaterials Science

Background:

• Revision Total Hip Arthroplasty (THA) presents challenges in restoring bone stock and hip biomechanics.
• Acetabular impaction bone grafting (AIBG) is a technique used to address bone loss.
• Traditionally, AIBG is performed in a single stage with component implantation, assuming graft loading is essential for integration.

Observation:

• A 73-year-old male with aseptic loosening and acetabular protrusion underwent a two-stage AIBG using irradiated femoral head allografts.
• The initial stage of the AIBG was performed without acetabular loading.

Findings:

• The irradiated femoral head allograft successfully integrated with the host bone despite the absence of acetabular loading during the first stage.
• This case is the first to demonstrate successful allograft integration in a two-stage AIBG without immediate acetabular loading.

Implications:

• The findings suggest that acetabular loading may not be a prerequisite for allograft integration in AIBG.
• This supports the potential for performing AIBG as a two-stage procedure in complex revision hip surgeries, particularly in patients with compromised bone stock.
• This approach may offer greater flexibility in managing challenging revision THA cases.