Abstract
PurposeRestoration cages and bone allografts have been proposed to manage severe acetabular bone defects. We aimed to investigate the migration behaviour of a restoration cup and impacted allograft bone in severe acetabular defects with Einzel-Bild-Röntgen-Analyse (EBRA).MethodsApplying a retrospective study design, 64 cases treated between 2009 and 2016 were reviewed. We determined the preoperative Charlson Comorbidity Index (CCI), pre- to postoperative WOMAC score, blood loss and functional outcome. From preoperative x rays, the acetabular deficiencies were classified according to Paprosky. Cup migration analyses were performed with EBRA.ResultsMean age at surgery was 73 (range: 38–93) years. According to the classification by Paprosky et al., 50% (n = 32) of our patients showed a type III B and 28.1% (n = 18) a type III A defect. Radiological follow-up for migration analysis was 35 (range: 4–95) months. Migration analysis showed a mean cup migration of 0.7 mm (range: 5.7–9.6) medial and 1.8 mm (range: 1.7–12.6) cranial.ConclusionIn conclusion, acetabular restoration cages in combination with bone impaction grafting showed a low revision rate at a mean follow-up of 35 months. Mean cup migration revealed low rates after 2 years and suggested a stable postoperative implant position.
Highlights
As the number of patients receiving total hip arthroplasty (THA) grows, the number of cases requiring revision surgery increases [1]
The rate of acetabular cup revision is gradually rising and there is a heightened risk for osteolysis, prosthesis loosening over time and an increase in life expectancy [2]
Patients with failed acetabular cup revision surgery frequently have severe bone cavities and segmented defects resulting in pelvic deficiency, and present a difficult situation for revision arthroplasty [3]
Summary
As the number of patients receiving total hip arthroplasty (THA) grows, the number of cases requiring revision surgery increases [1]. The rate of acetabular cup revision is gradually rising and there is a heightened risk for osteolysis, prosthesis loosening over time and an increase in life expectancy [2]. Patients with failed acetabular cup revision surgery frequently have severe bone cavities and segmented defects resulting in pelvic deficiency, and present a difficult situation for revision arthroplasty [3]. To restore the pelvic bone stock, the acetabular component should be placed in the correct anatomical position and the joint stability optimized [4]. The reconstruction should permit stable fixation of the new acetabular component and should lead to the restoration of the center of rotation [5, 6]. Bone impaction grafting has proven to be a helpful method for restoring
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