Acetabular Reconstruction with Impacted Morselized Allograft, Wire Mesh and Cemented Acetabular Cup in Severe Acetabular Bone Defect

ABSTRACT

PURPOSE: This study evaluated the clinical and radiographic results of an acetabular reconstruction with an impacted morselized allograft and wire mesh in revision total hip arthroplasty. MATERIALS AND METHODS: This study examined 21 cases of acetabular revisions involving 20 patients with a severe acetabular bone defect managed with an impacted morselized allograft, wire mesh and cemented acetabular cup between February 2000 and June 2003. The mean follow up period was 31.7 months. Clinically, the Harris hip score was evaluated. The radiographic parameters included bony incorporation between the host bone and allograft, the change in cup inclination, acetabular cup migration, radiolucency around the cup and loosening. RESULTS: The mean Harris hip score was improved from a preoperative 54.1 to 91.9 at the last follow up. Radiological incorporation between the host bone and allograft was achieved after an average 11.4 months after surgery. The mean change in cup inclination was 1.9 degrees, and the mean medial and superior migration was 3.93 mm and 4.41 mm respectively. The majority of these radiological changes occurred within 6 months after surgery. One case of Brooker grade I heterotopic ossification and one case of acetabular cup loosening was observed but there was no re-revision or complications, such as infection and dislocation. CONCLUSION: In a severe acetabular bone stock deficiency that cannot be reconstructed with a cementless acetabular cup, an acetabular reconstruction with an impacted morselized allograft, wire mesh and cemented acetabular cup showed good results in this short term follow up study.