Abstract
Introduction: Between 1990 and 2000 we reconstructed 123 hips in 110 patients using impaction bone grafting with frozen, morsellised irradiated femoral heads and cemented sockets. This review presents the medium to long term survivorship of irradiated allograft in acetabular reconstruction in our cohort of patients.
Patients and Methods: Patients were reviewed in out-patients. Radiographs were examined for union, lucency and component migration.
The mean age at revision with allograft was 64.3 years (26 to 97). 86 hips (70%) in 74 patients were reviewed both clinically and radiologically.
At the time of review 28 patients (29 hips) had died and 5 patients (5 hips) were lost to follow up. Of those patients who had died 18 hips had been followed up to a mean of 66 months (12–145). A further 3 hips were unable to attend for clinical review but had accurate implant-allograft survivorship data.
Their data were included in survivorship analysis to the time of last clinical review.
Results: There have been 19 revisions; 9 for infection, 7 for aseptic loosening and 3 for dislocation. In surviving acetabular reconstructions, union of the graft had occurred in 64 out of 67 hips (95.5%). Radiolucent lines at the bone cement interface were seen in 12 hips (17.9%; 9 in a single DeLee zone and 3 in multiple zones) but none were considered loose. Migration of the acetabular component greater than 5mm was seen in 3 hips (4.5%). Survivorship analysis using revision as an end point for all indications at 10 years was 83.3% (95% C.I. 68 to 89%) and 71.3% (95% C.I. 58 to 84%) at 15 years
Conclusion: Acetabular reconstruction using irradiated allograft and a cemented cup is an effective reliable technique with good results in the medium to long term comparable to series using non irradiated freshly frozen bone.
Correspondence should be addressed to BHS c/o BOA, at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London, WC2A 3PE, England.
