Revision Total Hip Arthroplasty Using Cementless Acetabular Cup / 대한정형외과학회잡지

ABSTRACT

PURPOSE: To evaluate the clinical and radiological results of revision total hip arthroplasty using cemetless acetabular cup and several kinds of morseled bone grafts. MATERIALS AND METHODS: We performed 20 cases of revision total hip arthroplasties between July 1993 and June 1996. Acetabular bone deficiency was classified as type I in 4 hips, type II in 13 hips, type III in 2 hips and type IV in one hip by AAOS classification. Autogenous bone graft was used in 10 cases, heterograft in 5 cases, allograft in 2 cases and a mixture with autografts and allografts in 2 cases. The average contact rate between cup and host bone was 33.5% in type I acetabular deficiency, 65.1% in type II, 50% in type III and 39% in type IV. RESULTS: The mean Harris hip score was 82.9 points at the last follow-up. Osseous union between host bone and graft bone occurred within 6 months in 14 cases. Radiological failure was noted in 8 cases at the last follow-up. Three cases were revised during the follow-up period. Five cases out of 7 cases in which the contact rate between acetabular cup and host bone was less than 50% were determined to be a radiologic failure. Only 2 cases of the 10 cases in which autogenous bone graft had failed grafts. The rate of complication was 7cases (35%). CONCLUSIONS: The usage of the hemispherical cementless acetabular cup with autogenous bone graft and increasing the contact rate between the acetabular cup and host bone could be a safe management method in revision total hip arthroplasty. We recomrnend avoiding the use of heterograft in cementless cup revision arthroplasty.