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KMID : 0386720030150020093
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Journal of the Korean Hip Society
2003 Volume.15 No. 2 p.93 ~ p.99
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Morselized Bone Grafting in Osteolytic Lesions around the Stable Cementless Acetabular Cup
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Yoo Myung-Chul
Cho Yoon-Je
Kim Kang Il
Chun Young-Soo
Kim SH
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Abstract
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Purpose: To analyze the clinical and radiological results of a curettage of granulation tissue, the exchange of polyethylene insert and morselized bone grafting for the treatment of osteolysis around a stable cementless acetabular cup.
Materials and Methods: 26 patients underwent operations using curettage of granulation tissue, the exchange of a polyethylene insert and morselized bone grafting, between April 1996 and July 2000. The average follow-up period was 3.5 years. Clinically, the Harris hip Score was used to evaluate the clinical results. Radiologically, the size of the osteolytic lesions in the anteroposterior and lateral views were measured, and a bone graft incorporation scale used to evaluate the graft bone union.
Results: Clinically, the average Harris Hip Score increases from 82 to 88 points postoperatively. The size of the osteolytic lesions changed from an average of 23.8mm×24.9mm to 11.5,mm×8.2mm postoperatively, in the AP view, and from 11.1mm×11.6mm to 5.3mm×4.5mm in the lateral view. The bone graft incorporation scales were Grades Ⅰ and Ⅱ in 12 and 14 cases, respectively, and new osteolytic lesions had not developed at the latest follow-up.
Conclusion: For the treatment of osteolysis around a stable cementless acetabular cup, curettage of granulation tissue, morselized bone grafting, and the exchange of a polyethylene insert can be effective treatments in preventing the progression of an osteolytic lesion and in the preservation of bone stock for further revision total hip replacements.
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KEYWORD
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Cementless acetabular cup, Osteolysis, Revision total hip replacement, Morselized bone graft
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