MEDIUM TERM RESULTS OF IMPACTION BONE GRAFTING OF ACETABULAR DEFECTS WITH IRRADIATED ALLOGRAFT BONE

Abstract

Irradiated allograft bone may help to reduce the risk of transmission of infectious agents from donor to recipient. The purpose of this study was to establish the results of impaction bone grafting of acetabular defects using irradiated allograft bone.

Patients treated with impaction bone grafting of ace-tabular defects between 1994 and 2000 were reviewed retrospectively. The mean follow-up was 50months (range 30–96months). Case notes and Xrays were reviewed and analysed. The Paprosky grade of acetabular defects was determined. Functional outcomes were determined by way of self-administered questionnaires.

Complete records and Xrays were obtained for 33 patients who underwent impaction bone grafting of the acetabulum using freeze-dried, irradiated bone. The Paprosky classifications of the defects were as follows: 3 type 1, 10 type 2A, 4 type 2B, 4 type 2C, 10 type 3A and 2 type 3B.

There were no complications associated with the bone grafts and no patient required reoperation. Review of serial Xrays confirmed ingrowth of host bone. The functional results obtained were as follows: 17 patients (52%) could walk an unlimited distance. 11 patients (33%) required no walking aids whilst a further 17 (52%) required a single cane to mobilise. 21 patients (64%) were able to use public transport after the operation. 20 patients (61%) reported little or no pain. 9 patients (28%) had no limp and 14 patients (42%) had a slight limp. Overall 29 patients (88%) declared themselves to be satisfied with the outcome of their surgery. 32 patients (97%) improved functionally after their operation.

These results indicate that satisfactory results can be achieved with impaction bone grafting using irradiated, frozen allograft bone. The use of irradiated bone graft can potentially reduce the risks of disease transmission from donor to recipient without compromising the surgical results.