Original ArticlesRevision total hip arthroplasty with the use of structural acetabular allograft and reconstruction ring: A case series with a 10-year average follow-up*,**,*
Section snippets
Materials and methods
Between January 1, 1980, and May 1993, 20 consecutive massive structural acetabular allografts and reconstruction rings performed were retrospectively reviewed. In all cases, the magnitude of the acetabular bone deficiency was such that the allograft supported >50% of the cup to restore normal anatomy, bone stock, and leg length. All procedures were performed by 1 surgeon and had a minimum follow-up of 5 years.
Of the 20 patients, 7 died of unrelated causes. Three patients (3 allografts)
Results
Twelve patients (13 allografts) were available for analysis, of which 3 patients (3 allografts) underwent resection arthroplasty, leaving 9 patients (10 allografts) for our study (Figs. 3 and 4).
Discussion
The increasing severity of acetabular bone loss translates into more complex acetabular reconstruction. One technique that can aid the orthopaedist in reconstructing the acetabulum and reconstituting bone stock is to use structural allografts. The use of structural allografts in the literature is controversial. Other studies have reported on and supported the use of structural allografts for massive acetabular defects 18, 28.
Paprosky et al [18] reported on 67 distal femoral allografts performed
Conclusion
The advantages of using a structural allograft include reconstitution of bone stock, restoration of the bone anatomy, and restoration of leg length. This study supports the use of massive structural allograft at an average of 10.5 years, achieving the aforementioned goals with satisfactory results in 77% if the graft is protected by a reconstruction ring. This study incurred a 7.7% (1 of 13) graft resorption rate and a 15.4% (2 of 13) recurrent dislocation rate treated with resection
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Cited by (104)
Mid-Term Results of Graft Augmentation Prosthesis II Cage and Impacted Allograft Bone in Revision Hip Arthroplasty
2018, Journal of ArthroplastyTreatment options for chronic pelvic discontinuity
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2017, Journal of ArthroplastyCitation Excerpt :The results of such reconstruction have been excellent according to multiple studies [23,25,26,28]; however, may have some potential disadvantages including the lack of bone-stock restoration, the difficulty of implanting an augment in an irregularly shaped bone defect and their high costs makes their use prohibitive in certain countries. Other treatment options include the use of a bilobed cups [18,19], cup-cage reconstructions [15,17,38], or custom triflange acetabular components [20,21]. Disadvantages of custom implants include considerable preoperative planning, the delays caused by custom implant fabrication and their costs.
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†University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada.
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No benefits or funds were received in support of this study.
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Reprint requests: Khaled J. Saleh, MD, MSc, FRSC, Department of Orthopaedic Surgery and School of Public Health, University of Minnesota, 420 Delaware Street, Box 492, Minneapolis, MN 55455.