Acetabular hip revision surgery with impacted bone grafts: Surgical technique and a case series

Abstract

Introduction: Impaction bone grafting technique is useful when the orthopaedic surgeon is faced with large cavitational acetabular defects with compressed particulate bone grafts, followed by insertion of either a cemented or cementless acetabular component. The technically demanding nature of the procedure, mandate the extensive training of the orthopedic surgeon who practiced the procedure.
Method: A case series study was performed from September 2006 to September 2011, including 27 patients with either acetabular or acetabular and femoral revision surgery with slight variations of the technique according to each particular case.
Result: Mean age of patients was 68.3 years (44 to 81). Among all included patients (27 patients), 21 were female and the remaining 6 were male. All prosthetic revision components were cemented. There was only one post-surgery hip dislocation. All cement bone interface radiolucent lines found were less than 1mm in length. A 2mm protrusio was found out in only one acetabular component along the first 2 follow up years, but it stopped by itself without the necessity of any further intervention.
Discussion: When philosophy underneath this surgical procedure is well understood by the surgeon, enough bone graft availability is being assure, a correct selection of candidate patient is performed, and when the procedure is performed by a well-trained orthopedic surgeon, results seems to be adequate to fairly recommend this technique.