Revision total hip arthroplasty without bone graft of high-grade acetabular defects Journal Article

Authors: Rees, H. W.; Fung, D. A.; Cerynik, D. L.; Amin, N. H.; Johanson, N. A.
Article Title: Revision total hip arthroplasty without bone graft of high-grade acetabular defects
Abstract: Mixed results have been reported with bulk and cancellous bone graft to fill defects during acetabular revision arthroplasty. Jumbo cups have been used to maximize host bone contact, and if adequate initial stability can be achieved, this approach may provide a superior long-term outcome. We retrospectively reviewed a consecutive series of 107 acetabular revisions performed using jumbo cups without bone graft. Bone defects were assessed using a validated radiographic classification system that yielded 64 hips with significant bone defects for inclusion. Mean change in American Academy of Orthopaedic Surgeons lower extremity core and pain scores and in Short Form-12 scores showed increases of 22.01, 37.52, and 17.08 points, respectively. Postoperative radiographs consistently demonstrated host bone ingrowth into the jumbo acetabular shells, except for 3 failures. Careful incremental reaming up to a size that optimizes host bone support and contact may eliminate the need for bone graft in most acetabular revision arthroplasties.
Keywords: Female; Humans; Middle Aged; Male; Severity of Illness Index; Retrospective Studies; Acetabulum; Reoperation; Prosthesis Failure; Prosthesis Design; Hip Prosthesis
Journal Title: The Journal of arthroplasty
Volume: 27
Issue: 1
ISSN: 1532-8406; 0883-5403
Publisher: Elsevier Inc  
Journal Place: United States
Date Published: 2012
Start Page: 41
End Page: 47
Language: eng
Notes: CI: Copyright (c) 2012; JID: 8703515; 2010/07/22 [received]; 2011/04/01 [accepted]; 2011/06/08 [aheadofprint]; ppublish