Reconstruction of acetabular bone defect by using bone grafting combining with titanium mesh and/or reinforcement cup in total hip arthroplasty / 中华骨科杂志

ABSTRACT

Objective To evaluate effect of bone grafting combining with titanium mesh and/or reinforcement cup in reconstruction of acetabular bone defect in total hip arthroplasty (THA).Methods From January 2008 to November 2011,32 patients,including 23 males and 9 females,aged from 51 to 76 years (average,66 years),underwent THA with acetabular defect reconstruction by using bone grafting combining with titanium mesh and/or reinforcement cup.There were 6 cases of primary THA and 26 cases of revision THA.Twelve cases (Paprosky Ⅱ B) and 7 cases (Paprosky Ⅱ C) underwent impaction bone grafting with titanium mesh; 6 cases (Paprosky Ⅱ C) underwent impaction bone grafting with reinforcement cup; 6 cases (Paprosky Ⅲ A) underwent impaction bone grafting and structural bone grafting with winged reinforcement cup; 1 case (Paprosky Ⅲ A) underwent double-layer impaction bone grafting with titanium mesh and reinforcement cup.Harris score and Gill classification were used to evaluate clinical and radiological results,respectively.Results All cases (32 hips) were followed up for an average of 22 months (range,12 to 25months).One year postoperatively,Harris score improved from preoperative 44.00±11.71 to postoperative 78.41 ±9.32.Twenty-four cases were excellent,4 good,4 fair,and the excellent and good rate was 87.5％.Three cases occurred mild displacement of acetabular rotation center; one case occurred dislocation.There was no loosing,subsidence,and bone resorption in other 28 cases at final follow-up.ConcLusion Bone grafting with titanium mesh and/or reinforcement cup is effective in reconstruction of acetabular bone defect in THA,which can improve the stability of acetabular cup.