Cortical and cancellous morselized allograft in acetabular revision total hip replacement: minimum 5-year follow-up.

Overview

Sixty patients who had had revision acetabular components with impaction morselized bone graft were studied in a retrospective, matched-pair analysis. In 30 patients, the morselized graft was derived from cortical bone (group A), and in 30 patients, the graft was derived from cancellous bone (group B). The patients were matched for age, gender, weight, comorbid conditions, Charnley category, severity of bone loss, and allograft preparation. At the time of follow-up, a mean of 7.4 years (range, 5-9 years) after surgery, the mean Harris Hip Scores in groups A and B were 84 and 77, respectively. Cup migration of 5 to 10 mm were noted in two patients in each group. Cup migration >10 mm was noted in 2 patients from group B and none in group A. Two patients in group A and 5 patients in group B underwent cup rerevision as a result of aseptic loosening. There was a correlation between progressive radiolucent lines extending 2 mm, cup migration, and clinical outcome. The current study showed that early and midterm clinical and radiologic outcomes such as cup migration >5 mm and radiolucent lines were significantly better using cortical morselized allograft. However, further mechanical and histologic evaluations should be performed that demonstrate the difference between these 2 types of morselized allograft.