Treatment of Acetabular Defects during Revision Total Hip Arthroplasty – Preliminary Clinical and Radiological Outcome Using Bone Substitute Materials

Acetabular defects are a particular challenge during THR revision. Defects may be filled with autologous bone grafts, allografts or synthetic bone substitute materials. In this preliminary, retrospective study, 22 patients were treated with an oval shaped revision cup and a combination of synthetic bone substitute materials, namely hydroxyapatite and beta-tricalcium phosphate. The postoperative outcome was evaluated regarding the functional clinical outcome and quality of life using the Harris hip score, the WOMAC and the SF-36. Signs of loosening and changes of the implant position were evaluated from plain radiographs. Follow up examinations were performed after an average duration of 20.5 months (7-33 months). Postoperatively, we found a significant increase of the Harris hip score, and an increase in both the SF-36 and the WOMAC scores (without statistical significance). No radiographic signs of loosening were evident at the time of follow up.

The use of synthetic bone substitute materials offers a possible alternative to the use of autologous and allogenic bone grafts in acetabular revision surgery. Further randomised controlled long-term studies are needed to verify the promising short-term results and to determine potential side effects, such as possible third body wear.