Impacted Bone Graft in Revision Acetabulum Surgery: A clinical experience

Document Type : Original Article

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Department of Orthopedic Surgery, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt.

Abstract

Background: With the advancement of hip surgery and increased life span in many nations, the need for acetabular revision surgery is expected to grow. Many options are available for such surgery, including the use of impacted bone graft. 
The Aim of The Work:  This work aimed to assess the clinical results of impacted bone graft in reconstructing the acetabular bone defect after a failed hip surgery.
Patients and Methods: Between 2013 and 2019, we performed reconstructions of the acetabulum for 20 patients, who had at least one acetabular operation before revision. Surgical reconstruction was conducted using an impacted cancellous bone graft. Each patient was directed to long-term clinical [primary outcome] and radiological evaluations. The direct postoperative clinical and radiographic outcomes were evaluated and the patient continued regular follow up visits for at least 12 months after surgery.
Results: According to the modified Harris-Hip [MHH] score, the results rated as excellent [35%], good [25%], fair [25%] and poor [15%]. No pain was recorded for 40%, slight pain for 30%. Thirteen patients [65%] were able to walk alone without support, while the remaining 7 used a support in the form of a cane [25%] or crutches [10%]. Leg-length discrepancy [>2.5 cm] was reported in two patients.
Conclusion: Successful results were obtained using the impaction technique for acetabular reconstruction, with restoration of near normal mechanics. The union rate is satisfactory. Augmentation of the grafting technique by mesh or rings added more stability to the cup component. 

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