The use of morselized allografts without impaction and cemented cage support in acetabular revision surgery: a 4- to 9-year follow-up

Background

Acetabular revision arthroplasty with major bone loss is one of the most difficult operations in orthopedic surgery. The goal of the study was to evaluate midterm clinical results of the use of morselized allografts with cemented cage support in revision total hip replacement.

Methods

We identified 28 patients (29 hips) at an average follow-up of 73 months. Harris Hip Scores (HHS) were assessed before and after surgery. Pre- and postoperative radiographs were evaluated for restoration of the center of rotation, component migration, and graft incorporation.

Results and discussion

At follow-up, the mean HHS improved from 34 (range, 20–45) to 80 (range, 71–98) points. None of the components had been re-revised. On average, the revised hip center of rotation was improved significantly. Incorporation of the graft was complete in 23 hips. The midterm result of cage reconstruction with morselized bone allograft is relatively better than other studies using a similar cage construction. We believe we have three special modifications of this reconstruction technique that are beneficial for bone incorporation.

Conclusions

These data confirm that acetabular reconstruction using morselized allografts and cemented acetabular cages is effective in the midterm as a treatment for acetabular loosening with massive bone deficiency.