Favorable survival of acetabular reconstruction with bone impaction grafting in dysplastic hips

Clin Orthop Relat Res. 2008 Feb;466(2):359-65. doi: 10.1007/s11999-007-0048-8. Epub 2008 Jan 10.

Abstract

Acetabular bone loss hampers implantation of a total hip arthroplasty in patients with developmental dysplasia of the hip. The bone impaction grafting technique in combination with a cemented total hip can restore the bone stock in these patients, but do these reconstructions yield satisfying long-term results? We used this technique in 28 hips (22 consecutive patients). The degree of dislocation was graded preoperatively as Crowe I in five hips, Crowe II in eight hips, Crowe III in nine hips, and Crowe IV in four hips. We present the long-term results of this bone impaction grafting technique a minimum of 10 years after surgery. Two patients died before the minimum followup of 10 years, leaving 20 patients (26 hips). Two cups were revised, one cup for a sciatic nerve palsy (at 2 years) and the other for aseptic loosening after 12 years. The cumulative survival of the cup with revision for any reason as the end point was 96% at 10 years and 84% at 15 years. There were no femoral revisions during followup. The bone impaction grafting technique in combination with a cemented cup is an effective technique for developmental dysplasia of the hip with favorable long-term results.

Level of evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

MeSH terms

  • Acetabulum / diagnostic imaging
  • Acetabulum / surgery*
  • Adult
  • Aged
  • Arthroplasty, Replacement, Hip / adverse effects
  • Arthroplasty, Replacement, Hip / instrumentation
  • Arthroplasty, Replacement, Hip / methods*
  • Bone Transplantation*
  • Female
  • Follow-Up Studies
  • Hip Dislocation, Congenital / diagnostic imaging
  • Hip Dislocation, Congenital / surgery*
  • Hip Prosthesis*
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications
  • Prosthesis Failure
  • Radiography
  • Retrospective Studies
  • Treatment Outcome