Abstract
Introduction and Objectives: Acetabular bone defects in hip replacement therapy present difficulties in terms of achieving stable, long-lasting fixation of the implant. Various surgical techniques exist to correct this problem. In this study we analysed the clinical and radiographic progression of a series of patients treated with fragmented grafts using the X-Change acetabular revision method.
Materials and Methods: From November 1988 to February 1998, 24 patients were treated, with an average age of 64.5 (±7) at the time of surgery. Patients were evaluated clinically preoperatively and were evaluated using the Harris scale at the end of the follow-up period. Defects were classified according to Paprosky’s classification of acetabular bone defects. Radiographic studies were used to evaluate upward and medial migration of the acetabular component and to look for signs of loosening. Follow-up time was a minimum of 12 months, with an average of 56.2 months.
Results: Average score on the Harris scale went from 49.7 points (±12.9) preoperatively to 88.2 points (±14.1) on follow-up. There was no graft incorporation in 5 patients (20%). There were 3 infections, 2 prosthetic dislocations, and one case of pulmonary thromboembolism. Upward migration of the cup (from the upper obturator line) was 0.48 cm (±0.72) postoperatively and 0.48 cm (±0.84) at follow-up. Medial migration (measured from Kohler’s line) was −0.16 cm (±0.50) postoperatively and −0.09 cm (±0.56) on follow-up. Cup angle (measured at the anteroposterior plate of the pelvis) changed from 48.9° (±5°) to 56° (±7°) at the conclusion of the follow-up period.
Discussion and Conclusions: This reconstructive technique provides stable, long-lasting fixation of the implant with complication rates similar to those described in the literature. We consider it a useful technique in the management of this type of defect, particularly in young patients who need to recover acetabular bone stock.
The abstracts were prepared by Dr. E. Carlos Rodríguez-Merchán, Editor-in-Chief of the Spanish Journal of Orthopaedics and Traumatology (Revista de Ortopedia y Traumatología). Correspondence should be sent to him at Sociedad Española de Cirugía Ortopédica y Traumatología (SECOT), Calle Fernández de los Ríos, 108, 28015-Madrid, Spain
