Treatment of large acetabular defects: a surgical technique utilizing impaction grafting into a metallic mesh.

Overview

BACKGROUND: Revision total hip arthroplasty in cases with severe acetabular bone loss is challenging. In the presence of combined cavitary and segmental defects without superior acetabular coverage, reconstructions with a structural acetabular allograft protected by a cage or a custom-made triflange cage have been the treatment of choice. The current paper describes an impaction grafting into a mesh for uncontained defects in revision total hip arthroplasty. DESCRIPTION OF TECHNIQUE: After restoring containment with a mesh fixed with small fragment screws, defects were restored using impaction grafting combined with a cemented all-polyethylene cup. PATIENTS AND METHODS: Fourteen consecutive acetabular impaction graftings were performed by two surgeons. All patients had a type 3B defect according to the Paprosky classification. RESULTS: No re-revisions or radiographic failure was detected in the early follow-up period. CONCLUSION: Impaction grafting into a mesh is an interesting treatment option to restore bone in combined cavitary and segmental defects.

HSS journal : the musculoskeletal journal of Hospital for Special Surgery Journal