Bone impaction grafting with trabecular metal augments in large defects in young patients: unravelling a new perspective in surgical technique

BMC Musculoskelet Disord. 2020 Aug 27;21(1):581. doi: 10.1186/s12891-020-03591-w.

Abstract

Background: Acetabular reconstruction with bone impaction grafting in large defects has yielded conflicting results.

Methods: This was a retrospective study of a case series of five patients with a young age (≤50 years) at the time of surgery who had large acetabular defects reconstructed by bone impaction grafting and trabecular metal augments. The mean follow-up was 79 months. We describe the surgical technique in detail.

Results: Improvement was significant on the WOMAC and SF-36 scales (p < 0.05). The radiographs taken at the last follow-up examination showed no migration of the polyethylene cup (p = 0.31) or differences in the abduction angle (p = 0.27) compared to the radiographs from the immediate postoperative period. One patient presented two dislocation episodes as a complication.

Conclusion: The combination of trabecular metal augments with the bone impaction grafting technique in young patients with large acetabular defects provides satisfactory results in the long term and restores the bone stock.

Keywords: Bone impaction grafting; Large acetabular defects; Trabecular metal augments; Young revision patients.

MeSH terms

  • Acetabulum / diagnostic imaging
  • Acetabulum / surgery
  • Arthroplasty, Replacement, Hip* / adverse effects
  • Bone Transplantation
  • Follow-Up Studies
  • Hip Prosthesis*
  • Humans
  • Middle Aged
  • Prosthesis Failure
  • Reoperation
  • Retrospective Studies
  • Treatment Outcome