Revision total hip replacement in severe acetabular bone deficiency

ABSTRACT

Acetabular bone deficiency is one of the main problems in hip revision. The aim of this study is to evaluate the results of revision hip replacement using stemmed acetabular component. Twenty one hips in 18 patients had revision total hip replacement using the stemmed acetabular reinforcement ring and impaction grafting technique for reconstruction of type III [combined segmental / cavitary] acetabular bone deficiency. A new method of measurements of migration was developed using a personal computer, scanner and a new software [Roman] developed in Robert Jones and Agnus Hunt Orthopaedic Institute, Oswestry, United Kingdom. The overall results revealed satisfactory results in 18 hips [90%] after a mean period of follow-up of 3.8 years. Failure was in 2 cases [10%] due to infection. The mean postoperative hip score improved from 50 points to 87.3 points. The mean vertical migration was 4.57 mm while the mean horizontal migration was 4.11 mm. 2 patients showed significant radiolucent lines and the cup was considered loose. 4 hips [19%] showed grade I heterotopic ossification [HO], one hip [5%] showed grade II HO. and one [5%] had grade III HO. 16 hips [76%] showed complete incorporation of the bone graft. Two hips [10%] had deep infection and considered clinical and radiological failure. Five hips had post operative dislocation and were managed conservatively without the need for any surgical intervention