The Results of Acetabular Impaction Grafting in 129 Primary Cemented Total Hip Arthroplasties

• Published in: The Journal of arthroplasty 2013-09, Vol.28 (8), p.1394-1400
• Main Authors: Wilson, Matthew J., FRCS (Orth), Whitehouse, Sarah L., PhD, Howell, Jonathan R., MSc, FRCS (Orth), Hubble, Matthew J.W., FRCS (Orth), Timperley, A. John, FRCS, DPhil (Oxon), Gie, Graham A., FRCSEd (Orth)
• Format: Article
• Language: English
• Subjects: acetabulum; Acetabulum - surgery; Adult; Aged; Aged, 80 and over; Arthroplasty, Replacement, Hip - methods; Bone Cements; Bone Transplantation - methods; cement; Female; Follow-Up Studies; Hip Dislocation - surgery; Hip Joint - diagnostic imaging; Hip Joint - surgery; Hip Prosthesis; Humans; impaction grafting; Incidence; Kaplan-Meier Estimate; Male; Middle Aged; Orthopedics; Osteoarthritis, Hip - surgery; Prosthesis Failure; Radiography; Retrospective Studies; socket; Spondylitis, Ankylosing - surgery; survival; Treatment Outcome
• ISSN: 0883-5403; 1532-8406
• DOI: 10.1016/j.arth.2012.09.019

Abstract Between 1995 and 2003, 129 cemented primary THAs were performed using full acetabular impaction grafting to reconstruct acetabular deficiencies. These were classified as cavitary in 74 and segmental in 55 hips. Eighty-one patients were reviewed at mean 9.1 (6.2–14.3) years post-operatively. There were seven acetabular component revisions due to aseptic loosening, and a further 11 cases that had migrated > 5 mm or tilted > 5° on radiological review — ten of which reported no symptoms. Kaplan–Meier analysis of revisions for aseptic loosening demonstrates 100% survival at nine years for cavitary defects compared to 82.6% for segmental defects. Our results suggest that the medium-term survival of this technique is excellent when used for purely cavitary defects but less predictable when used with large rim meshes in segmental defects.