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Impaction grafting and acetabular reinforcement in revision hip replacement
R P Pitto1, G V Di Muria, D Hohmann
1Orthopädische Klinik der Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany.
International Orthopaedics
|September 5, 1998
Summary
Revision hip replacement using bone grafting and reinforcement implants shows high patient satisfaction and successful bone stock restoration. This technique effectively addresses bone loss in complex hip revision surgeries.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
Background:
- Significant bone stock loss is common in revision hip replacement surgeries.
- Impaction grafting with bone chips (autologous and homologous) is a biological approach for bone defect management.
- Reinforcement implants offer structural support for prostheses and graft protection during healing.
Purpose of the Study:
- To evaluate the clinical and radiological outcomes of revision hip acetabular cups with aseptic loosening.
- To assess the efficacy of impaction grafting combined with reinforcement implants in restoring bone stock and achieving stable fixation.
Main Methods:
- Retrospective analysis of 81 revision hip replacement surgeries in 78 patients.
- Utilized a combination of autologous and homologous bone chips for impaction grafting.
- Employed reinforcement implants to secure the new prosthesis and protect the bone graft.
Main Results:
- 93% patient satisfaction at an average 6.5-year follow-up.
- Complete graft fusion observed in all cases by 3 months post-operation.
- Increased bone stock in all patients, with minor graft resorption in 6 cases.
- No signs of implant loosening detected; one case required revision for dislocation, one for superficial infection.
Conclusions:
- Impaction grafting with reinforcement implants is an effective method for managing bone loss in revision hip replacement.
- This technique provides primary fixation and secondary stability, leading to encouraging clinical and radiological results.
- Careful preoperative planning and intraoperative assessment are crucial for optimal graft incorporation and prosthesis selection.