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FACTORS AFFECTING THE OUTCOME OF SOCKET FIXATION AFTER REVISION WITH BONE GRAFTING



Abstract

Factors influencing the results of revised cemented sockets with bone grafting have been studied in 249 cases.

Freeze-dried allografts in 77 and fresh frozen in 172 cases have been used. The average follow-up was 8 years 11 months for the freeze-dried group and 2 years 11 months for the fresh frozen cases. There were 13 postoperative dislocations, 20 TNU, 4 thromboembolic complications, 4 delayed wound healing and 2 intraoperative fractures of the acetabulum. There have been 11 re-revisions: 8 for aseptic loosening, 2 for dislocation and 1 for infection. Radiographic evidence of loosening was seen in another 38 cases.

The acetabular bone stock at the time of revision and initial stability of socket fixation had a significant influence on the outcome. Direction of socket migration before surgery appeared to predict risk of failure. The primary pathology, type of bone graft and grafting technique also had an effect.

Editoral Secretary Mr Peter Howard. Correspondence should be addressed to BHS at the Royal College of Surgeons, 35 - 43 Lincoln’s Inn Fields, London WC2A 3PN.