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Clinical Orthopaedics and Related Research®
Published in: Clinical Orthopaedics and Related Research® 12/2010

01-12-2010 | Symposium: Papers Presented at the 2009 Closed Meeting of the International Hip Society

The Survival and Fate of Acetabular Reconstruction With Impaction Grafting for Large Defects

Authors: Eduardo Garcia-Cimbrelo, MD, PhD, Ana Cruz-Pardos, MD, PhD, Eduardo Garcia-Rey, MD, PhD, EBOT, José Ortega-Chamarro, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 12/2010

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Abstract

Background

Impaction bone grafting has been used for acetabular reconstruction in revision surgery. However, most series do not establish differences in survival in revisions with differing severity of bone loss.

Questions/purposes

We therefore determined (1) the survival rate for rerevision associated with varying degrees of bone loss; (2) the frequency with which bone graft resorption occurred; and (3) whether the reconstruction restored the anatomic center of rotation of the hip.

Methods

We retrospectively reviewed 165 patients (181 hips) who underwent rerevision for major bone loss. Using the classification of Paprosky et al. 98 hips had a Grade 3A defect and 83 a Grade 3B. We determined survival rates for revision and graft resorption. Cup position was determined measuring vertical and horizontal positions and the distance from the center of the prosthetic femoral head to the normal center of rotation of the hip in both groups according to Ranawat. The minimum followup until rerevision or the latest evaluation was 0.3 years months (mean, 7.5 years; range, 0.3–17.7 years).

Results

The survival rate for revision at 8 years was 84% (95% confidence interval: 61–100) for Grade 3A and 82% (95% confidence interval: 68–100) for Grade 3B. Twelve hips were rerevised. Seventeen grafts showed bone resorption. Acetabular cup position was anatomically restored in both Grades 3A and 3B.

Conclusions

The midterm results for impacted bone allograft and cemented all-polyethylene cups were similar in both Grade 3A and Grade 3B hips. Acetabular reconstruction allows anatomic positioning of the cups and is associated with a low rate of rerevision.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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Metadata
Title
The Survival and Fate of Acetabular Reconstruction With Impaction Grafting for Large Defects
Authors
Eduardo Garcia-Cimbrelo, MD, PhD
Ana Cruz-Pardos, MD, PhD
Eduardo Garcia-Rey, MD, PhD, EBOT
José Ortega-Chamarro, MD
Publication date
01-12-2010
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 12/2010
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-010-1395-4

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