KMID : 0386720060180040153
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Journal of the Korean Hip Society 2006 Volume.18 No. 4 p.153 ~ p.159
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Cementless Acetabular Revision Performed with Morselized Bone Grafts:A Ten-Year Minimum Follow-Up
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Shin Seung-Han
Kim Young-Min Yoon Kang-Sup Koo Kyung-Hoi Yoo Jeong-Joon Nam Kwang-Woo Kim Hee-Joong
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Abstract
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Purpose: We evaluated the results of cementless acetabular revisions performed with morselized bone grafting and screw-fixed hemispherical cups with different surface treatments.
Materials and Methods: Forty hips, which had been followed for more than 10 years, were included in this study. Reconstruction was performed with 10 hydroxyapatite (HA)-coated cups and 30 porocoated ones. The mean followup time was 12 years and 1 months (range, 10 years to 15 years). Re-revision or radiographic loosening was considered as an endpoint of follow-up.
Results: The average Harris hip score improved from 52 points to 75 points. During the follow-up period, radiographic loosening was observed in 17 hips. The loosened implants were HA-coated cups in 8 hips and porocoated ones in 9 hips. In 14 of these, re-revision of the cups was performed. The re-revision rate was 20% for the porocoated cups and 80% for the HA-coated cups. There were 2 hips with liner wear, which had undergone liner and head changes. Bone grafts were united in all the hips. The average time to union was 5.2 months (range, 2 to 9 months), and the average time to incorporation was 12 months (range, 5 to 18 months).
Conclusion: Our results imply that HA-coated cups have a significantly higher failure rate compared with the porocoated ones (P<0.05) after a minimum follow-up of 10 years. Morselized bone grafting with use of a porocoated cup is an effective modality, which can restore the bone loss of the acetabulum in revision total hip arthroplasty.
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KEYWORD
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Acetabular revision, Cemetless, Morselized bone graft, Porocoated, Hydroxyapatite
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