Acetabular reconstruction with impaction bone grafting and cemented polyethylene socket in total hip revision arthroplasty

Scand J Surg. 2015 Dec;104(4):267-72. doi: 10.1177/1457496914568408. Epub 2015 Feb 13.

Abstract

Background and aims: Bone deficiency in revision total hip arthroplasty is a challenge to the surgeon. One option for restoration of the bone stock is impaction bone grafting and use of a cemented socket. The aim of this study was to evaluate the mid-term clinical outcome of impaction bone grafting and cemented socket revisions.

Material and methods: A total of 59 patients (60 hips) underwent revision arthroplasty with impaction bone grafting and application of a cemented socket on the acetabular side in the Turku University Hospital from 1999 to 2004. The study end-point was re-revision for any reason. The cumulative percentages for survival were followed and estimated with Kaplan-Meier curves. Associations between occurrence of re-revision and potential risk factors were analyzed with logistic regression. Results were quantified by odd ratios and 95% confidence intervals. The mean age of the patients was 69 years (33% male). A total of 3% of the patients had a class I Paprosky acetabular defect, 38% had class II, and 55% had class III.

Results: The overall survival rate was 73%. The mean follow-up time was 7 years. The most common reason for re-revision was aseptic loosening of the acetabular component (13 patients, 81% of re-revisions). Cox's regression analysis did not identify any risk factors for re-revision.

Conclusion: Our results were inferior compared to some previous studies. Impaction bone grafting of acetabular defects in revision total hip arthroplasty may not always provide a reliable bone stock in long-term.

Keywords: Impaction bone grafting; acetabular reconstruction; revision hip arthroplasty.

MeSH terms

  • Acetabulum / surgery*
  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Arthroplasty, Replacement, Hip / mortality
  • Bone Cements*
  • Bone Transplantation / methods*
  • Female
  • Finland / epidemiology
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Osteoarthritis, Hip / surgery*
  • Plastic Surgery Procedures / methods*
  • Polyethylene*
  • Postoperative Complications
  • Prosthesis Design
  • Prosthesis Failure
  • Reoperation
  • Retrospective Studies
  • Survival Rate / trends
  • Treatment Outcome

Substances

  • Bone Cements
  • Polyethylene