Jumbo cups and morsalized graft

Acetabular revision surgery remains a complex challenge, especially when significant bone loss is present. Traditional approaches struggle to provide stable fixation in such cases. Prior research has shown that cemented components often fail under these conditions. Bone loss and sclerosis further complicate implant placement. Surgeons have sought alternatives that can integrate with remaining host bone. Porous-surfaced implants have emerged as a potential solution. These implants allow for osseointegration even with limited bone stock. However, gaps remain in understanding how to manage large acetabular defects effectively.

This study aimed to evaluate the effectiveness of jumbo uncemented acetabular components combined with morsalized bone grafts. The focus was on patients with major acetabular bone loss. The goal was to assess long-term fixation stability in these challenging cases. Surgeons needed evidence on whether such implants could avoid failure. The study also aimed to determine if grafting large defects improved outcomes. Patients without pelvic discontinuity were selected to isolate the effect of the technique. A ten-year follow-up was chosen to capture long-term results. The findings could inform revision strategies in complex acetabular cases.

The study reviewed 19 acetabular revisions performed between 1986 and 1988. Jumbo uncemented components with outer diameters of 70–80 mm were implanted. These components were stabilized using supplemental screws. Morsalized bone grafts were used to fill large defects. Radiographic assessments were conducted at follow-up visits. The mean follow-up period was ten years. One case was revised for sepsis, while others remained unrevised. Definite radiographic failure was not observed in any of the hips.

All 19 revisions showed stable fixation of the acetabular components. No cases of definite radiographic failure were recorded. The mean follow-up period was ten years, with a range of eight to eleven years. One implant was revised due to sepsis, not mechanical failure. No other implants required revision for fixation issues. Morsalized grafts effectively supplemented bone stock in large defects. Jumbo components provided stability even in the absence of significant host bone. These findings suggest the technique is viable for major bone loss.

The authors propose that jumbo uncemented acetabular components with morsalized grafts are effective in major bone loss cases. The ten-year follow-up supports long-term stability of these implants. No radiographic failures were observed in the study group. The use of morsalized grafts appears to enhance bone stock restoration. Surgeons may consider this approach when cemented components are unsuitable. The results suggest the method is reliable in the absence of pelvic discontinuity. The authors emphasize the importance of supplemental screws for stability. These findings contribute to the evolving field of acetabular revision techniques.