Abstract
BACKGROUND
Acetabular defects are encountered in both primary total hip arthroplasty (THA) in patients with developmental dysplasia of the hip (DDH) and in revision THA. The purpose of this study was to evaluate the clinical and radiographic results of one method of acetabular reconstruction for THA using a hydroxyapatite (HA) block with either an autogenous graft or allograft of impacted morsellized bone in conjunction with a cemented socket.
METHODS
Fourteen hips in 14 patients (all female; average age, 64 years) were treated with the above technique in primary (11 DDH) or revision THA (three loosened sockets). All patients were followed clinically in a prospective fashion, and radiographs were analyzed retrospectively. One initial patient had 16-year follow-up, whereas the remaining 13 patients had follow-up between four and 5.5 years.
RESULTS
No acetabular components were revised, including the socket of 16-year postoperative case which remains rigidly fixed and supported by the graft and HA block with only mild polyethylene wear and minor osteolysis. The mean Japanese Orthopaedic Association (JOA) score for the hips improved from 37 points preoperatively to 90 points postoperatively.
CONCLUSIONS
The authors report very good results of acetabular reconstruction with the use of these biomaterials in conjunction with impaction morsellized bone graft in THA. Osteointegration and good clinical outcome were achieved in all of cases. However longer-term outcome should be the subject of further investigation, as the majority of these patients had only mid-term follow-up of 4 to 5.5 years.
