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298. RECONSTRUCTION OF THE ACETABULUM WITH ALLOGRAFTS



Abstract

Purpose of the study: Reconstruction of the acetabulum is becoming increasingly necessary due to the longer life expectancy of patients with a total hip arthroplasty (THA); it can also be needed after trauma or resection of a bone tumour.

Material and methods: For 39 cases, we used a bone bank acetabulum with variable size for simple reconstruction of a part of the acetabulum (n=6) or to replace the entire acetabulum (n=19) or even an entire hemi-pelvis (n=14) in patients with more or less extensive bone loss. For 18 cases, resection was necessary to remove a bone tumour (16 chondrosarcomas and two giant-cell tumours), in 19 cases the reconstruction was necessary after multiple operations, and in four others due to traumatic destruction.

Results: Allograft integration was successful in nearly all patients (two cases of necrosis required a secondary prosthesis, 12.5%) and in two cases we noted immunological reactions with a serous effusion. There were no local infections. For osteocartilaginous acetabuli (n=7) the integration was quite satisfactory, certain patients have been followed for more than 26 years with no evidence of osteoarthritis.

Discussion: Use of a well-established protocol for hypothermia and the absence of secondary sterilisation yields grafts with preserved mechanical properties. The use of cyropreserved osteocartilaginous allografts offers hip for good integration free from degenerative osteoarthritis.

Correspondence should be addressed to Ghislaine Patte at sofcot@sofcot.fr