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KMID : 0386720020140030194
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Journal of the Korean Hip Society
2002 Volume.14 No. 3 p.194 ~ p.202
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Acetabuloplasty (shelf reconstruction) using Structural Bone Graft in Cementless Total Hip Arthroplasty
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Yoo Myung-Chul
Cho Yoon-Je
Kim Kang Il
Chun Young-Soo
Shin Dong-Jun
Bae Sung-Chul
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Abstract
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Introduction : We analyzed 46 patients (48 hips) who had undergone structural bone graft during total hip arthroplasty (THA).
Materials and Methods : There were 15 male and 31 female patients with an average age of 38 years. Underlying causes were hip dysplasia in 21 hips, infection sequelae in 16, failed THA in 6, and the others in 5 hips The average follow-up period was 8.2 years. Cementless acetabular components were used in all cases, the types being cementless harris-Galante Ⅰ in 25 cases, Ⅱ in 20, and truncated cup in 3. Grafted bones were autogenous from the extracted femoral head in 38 hips, fresh frozen allograft in 7, and combined bone graft in 3. Clinical and radiographic evaluation was performed with Harris hip score, cup-graft contact area, union of grafted bone, and prosthesis stability.
Results: Harris hip score was improved from 63 points preoperatively to 88 points postoperatively. The amount of cup-graft contact area averaged 37.5%. Graft resorption was noted in 18 hips. There were no differences in failure rate between the amount of cup-graft contact area and the degree of resorption. Acetabular revision was performed in 6 cases due to osteolysis in 2 cases, dissociation of polyethylene liner in 2, and wear in 2. No case showed loosening of the metal shell.
Conclusions : Acetabuloplasty using structural bone graft in acetabular deficiency showed promising results in intermediate term follow-up. Minimal graft resorptions were noted in some cases, but the grafted bone had provided sufficient initial and final structural support to ensure proper positioning of the acetabular component.
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KEYWORD
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Segmental uncontained bone deficiency, Total hip arthroplasty, Acetabuloplasty, Structural bone graft
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