Acetabular revision using a bone-ingrowth total hip component in patients who have acetabular bone stock deficiency

The clinical and radiologic results of acetabular revision using a porous titanium-mesh metal-backed acetabular component fixed to the pelvis with screws were studied in 30 consecutive patients (32 hips) who had moderate or severe acetabular bone loss. All of the acetabula were classified as type III or IV according to the American Association of Orthopaedic Surgeons' acetabular grading system. Particulate autologous or allogenic bone-graft was used in 75% of the reconstructions. The mean follow-up period was 69 months (range, 46-109 months). Three acetabular components (9%) were rerevised for aseptic loosening at an average of 64 months, including one patient who had a primary diagnosis of radiation necrosis of the ilium. The average Harris hip score for the remaining 29 hips rose from 46 to 81. The radiologic failure rate was 3% (1 of 29 unrevised hips) for a total failure rate of 12%. No pelvic osteolysis was seen with this implant. Revision of acetabula that have moderate or severe bone deficiency by a bone-ingrowth acetabular component fixed with screws and bone-graft appears to be successful in restoring bone stock and providing a stable, pain-free reconstruction.