Partially hydroxyapatite-coated stemmed acetabular cup and nonstructural bone-graft in the management of severe acetabular deficiency.

Abstract

We evaluated the use of a stemmed acetabular cup with morcellized allograft in the treatment of severe acetabular deficiency requiring reconstruction at arthroplasty. There were 29 hips, of which 22 were revision operations (18 aseptic, 4 postinfective) and 7 were complex primary hip replacements. All patients had severe acetabular deficiency as classified by the American Academy of Orthopaedic Surgeons: type IIB, 3; type IIIa, 18; type IIIB, 8. The patients had a mean follow-up of 46 months (range, 14-74 months). The hip center of rotation improved from a mean preoperative, side-to-side difference of 11.5 mm to 2.5 mm postoperatively (P < .001 ). The medial bone stock improved from a mean preoperative value of 1.5 mm to 11 mm postoperatively (P < .001). The Harris Hip Score improved from a mean preoperative score of 42 points to a postoperative score of 84 points (P < .001 ). There was 1 case of failure resulting from sepsis. The early results with this method of reconstruction of severe acetabular deficiency show encouraging restoration of bone stock, with no cases of aseptic loosening until the last follow-up.