Treatment of large acetabular defects: a surgical technique utilizing impaction grafting into a metallic mesh.
HSS J 2013;
9:242-6. [PMID:
24426876 PMCID:
PMC3772160 DOI:
10.1007/s11420-013-9350-z]
[Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Accepted: 07/09/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND
Revision total hip arthroplasty in cases with severe acetabular bone loss is challenging. In the presence of combined cavitary and segmental defects without superior acetabular coverage, reconstructions with a structural acetabular allograft protected by a cage or a custom-made triflange cage have been the treatment of choice. The current paper describes an impaction grafting into a mesh for uncontained defects in revision total hip arthroplasty.
DESCRIPTION OF TECHNIQUE
After restoring containment with a mesh fixed with small fragment screws, defects were restored using impaction grafting combined with a cemented all-polyethylene cup.
PATIENTS AND METHODS
Fourteen consecutive acetabular impaction graftings were performed by two surgeons. All patients had a type 3B defect according to the Paprosky classification.
RESULTS
No re-revisions or radiographic failure was detected in the early follow-up period.
CONCLUSION
Impaction grafting into a mesh is an interesting treatment option to restore bone in combined cavitary and segmental defects.
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