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General Orthopaedics

Outcome of acetabular bone grafting in revision hip arthroplasty: 5–20 year follow-up

British Orthopaedic Association/Irish Orthopaedic Association Annual Congress (BOA/IOA)



Abstract

Introduction

We present the outcome of 297 acetabular revisions using bone grafting and cemented acetabular components in 297 patients, with a mean follow-up of 8 years 3 months (5–20 years).

Methods

All patients underwent acetabular revision with allograft bone grafting and insertion of cemented acetabular components. Of the 297 patients, 134 patients (45%) were male and 163 (55%) were female. The mean age of undergoing revision surgery with bone grafting was 60 years (25–87 years). The mean weight at revision surgery was 71.9 kg (40–128 kg). Post-operatively, all patients were reviewed regularly in out-patients, where they were examined clinically for any complications and their radiographs were examined for evidence of graft union, radiological lucency and cup migration.

Results

Post-operatively, 61 patients suffered from early complications, which were defined as complications within one year of surgery. These included 15 dislocations (5%), 12 trochanteric non-unions (4%), 2 deep infection (0.7%), and 32 medical complications (11%). Thirty six patients (12%) have subsequently undergone re-revision surgery. Twenty four re-revisions were performed due to loose socket (8%), 12 for loose stem (4%), 3 for deep infection (1%), 2 for dislocation (0.7%) and 1 for fractured stem (0.4%). In all the cases of loose socket, radiolucent lines at the bone cement interface were noted.

Discussion

Reconstruction of the acetabulum during revision hip surgery using allograft and cemented cup is an effective technique with good short term results.