Abstract
Introduction: The main object of acetabular revisions in the presence of bone loss is to restore bone stock to provide adequate support for the cup. Allograft bone has been used to reconstruct the acetabulum with variable results.
Purpose of the study: Prospective assessment of the performance of the uncemented cups with morsellized allograft bone in revision acetabular reconstruction.
Patients and methods: A single surgeon using the lateral approach performed 98 acetabular revisions. An uncemented cup with multiple screw holes and morsellized allograft bone was used in all the patients. Acetabular defects were classified using both AAOS and Paprosky classification systems on standard AP x-rays and clinical assessment was by Harris hip scores.
Results: 93 patients had complete clinical and radiological follow-up. Mean age was 65.3 years (24–87) and majority was female. Mean number of prior operations was 1.7 (1–5). Majority of the acetabular defects belonged to group III (AAOS). The mean follow-up was 98 months (36–145). 13 patients have undergone repeat revisions, 5 for aseptic loosening and 3 each for infection, recurrent dislocation and early technical failures. Bone incorporation was complete within 3 months in all the cases
Discussion: The use of uncemented cups with screws provides the primary stability that is supplemented later by the incorporated allograft bone. The rate of re-operations for aseptic loosening of the cup in our series is low at 6% after 8 years. Even in these cases the repeat revisions were significantly easier due to restoration of the bone stock.
The abstracts were prepared by Professor Jegan Krishnan. Correspondence should be addressed to him at the Flinders Medical Centre, Bedford Park 5047, Australia.
