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Bone-grafting in total hip replacement for acetabular protrusion
The Journal of Bone and Joint Surgery. American Volume
|October 1, 1980
Summary
Bone grafting effectively reinforces the medial acetabular wall during total hip replacement for protrusio acetabuli, preventing further progression. This surgical technique shows promising results in stabilizing the hip joint.
Area of Science:
- Orthopedic Surgery
- Bone Grafting Techniques
- Hip Reconstruction
Background:
- Protrusio acetabuli presents a significant challenge in total hip replacement, often requiring acetabular wall reinforcement.
- Medial acetabular wall deficiency necessitates specialized surgical approaches to ensure joint stability.
Purpose of the Study:
- To evaluate the efficacy of homologous and autogenous bone grafts in reinforcing the medial acetabular wall.
- To assess the long-term outcomes of bone grafting in patients with painful protrusio acetabuli undergoing total hip replacement.
Main Methods:
- Retrospective analysis of 32 patients undergoing total hip replacement with bone grafting for protrusio acetabuli.
- Follow-up duration ranged from a minimum of two years to eight years.
- Utilized protrusio acetabuli rings for support in cases with absent medial acetabular walls until graft healing.
Main Results:
- Radiographic evidence of bone graft union within three months in all patients.
- No progression of acetabular protrusion observed post-operatively.
- Complications included late dislocation, pulmonary embolism, non-unions, fractured trochanters, and femoral component loosening.
Conclusions:
- Bone grafting is an effective method for arresting the progression of acetabular protrusion.
- Surgical reinforcement of the medial acetabular wall with bone grafts provides stability in total hip replacement for protrusio acetabuli.
- While complications exist, bone grafting demonstrates a positive impact on managing acetabular protrusion.