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Biological Repair of Acetabular Bone Defects and Cup Migration After Impaction Bone Grafting in Total Hip Arthroplasty

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Acetabular Revision Surgery in Major Bone Defects

Abstract

The rational way to reconstruct acetabular bone defects in revision surgery is to use the most biological way possible to restore and improve the bone stock through bone grafts, which will also form a solid foundation for further revisions, especially in young patients. This rationale has led us to apply impacting bone grafting with a cemented cup in many patients. This is a reliable technique for the treatment of large acetabular defects. However, proximal and medial migration of the cemented cup has been reported in some cases in all series. It could be due to a some difference in bone remodelling when cemented fixation is used in conjunction with bone impaction grafting. When a graft is well incorporated and the cup fails for mechanical reasons, the incorporation of the earlier graft should improve the bone stock situation and facilitate subsequent revisions. Consequently, we also recommend the use of impaction bone grafting in complex acetabular revision surgery to facilitate future revisions.

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García-Rey, E., García-Cimbrelo, E. (2019). Biological Repair of Acetabular Bone Defects and Cup Migration After Impaction Bone Grafting in Total Hip Arthroplasty. In: García-Rey, E., García-Cimbrelo, E. (eds) Acetabular Revision Surgery in Major Bone Defects. Springer, Cham. https://doi.org/10.1007/978-3-319-98596-1_6

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  • DOI: https://doi.org/10.1007/978-3-319-98596-1_6

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  • Online ISBN: 978-3-319-98596-1

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