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KMID : 0386720030150030225
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Journal of the Korean Hip Society
2003 Volume.15 No. 3 p.225 ~ p.230
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Treatment of Pelvic Osteolysis Associated with a stable Cementless Acetabular Cup with Morselized Bone Graft
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Suh You-Sung
Lim Kang-Chul
Kwan Hyuk-Yong
Yim Soo-Jae
Park Jong-Seok
Lee Byung-Ill
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Abstract
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Purpose: To evaluate the result of treatment for osteolysis around a stable cementless acetabular cup using curettage and a bone graft.
Materials and Methods: Ten patients (10 cases), having undergone curettage of granulation tissue, exchange_ of polyethylene insert and morselized bone grafts, were reviewed. The average follow up period was 2.6 years. In all cases a bone graft and exchange of the polyethylene insert in the acetabular components were performed. In 3 cases, the locking mechanism was unstable, so the insert was fixed using bone cement. The Harris Hip Score was adopted to judge the clinical results. Radiologically, the size of t"t osteolytic lesions and dissociation of the insert, in the anteroposterior and lateral views, on simple X rays were measured. A bone graft incorporation scale was used to evaluate the graft bone union.
Results: Clinically, the average Harris Hip Score had increased from 82 to 91 points at the last follow up. The average sizes of the osteolytic lesions in the AP and lateral views were 16.3 X 7 mm and 8.1 x 7.3 mm preoperatively, and 5.5 x 4.0 mm and 2.7 x 3.1 mm at the last follow up, respectively. The bone graft incorporation scales were Grades II and I in 7 and 3 cases, respectively. In all cases the bone union was satisfactory, and no new osteolytic lesions had developed at the last follow up.
Conclusion: After curettage of osteolytic lesions, and a bone graft, the exchange of a polyethylene insert and femoral head, without changing the acetabular components, for the treatment of osteolysis around a stable cementless acetabular cup, demonstrated satisfactory results on short term follow up. There was no new osteolysis in the graft bone union or increase in the size of the osteolytic lesions. The follow up period of this study was short, so further long term observation will be required.
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KEYWORD
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Osteolysis, Curettage, Bone graft, Cementless
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