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Treatment of Large Acetabular Defects: A Surgical Technique Utilizing Impaction Grafting into a Metallic Mesh

  • Surgical Technique
  • Published:
HSS Journal ®

Abstract

Background

Revision total hip arthroplasty in cases with severe acetabular bone loss is challenging. In the presence of combined cavitary and segmental defects without superior acetabular coverage, reconstructions with a structural acetabular allograft protected by a cage or a custom-made triflange cage have been the treatment of choice. The current paper describes an impaction grafting into a mesh for uncontained defects in revision total hip arthroplasty.

Description of Technique

After restoring containment with a mesh fixed with small fragment screws, defects were restored using impaction grafting combined with a cemented all-polyethylene cup.

Patients and Methods

Fourteen consecutive acetabular impaction graftings were performed by two surgeons. All patients had a type 3B defect according to the Paprosky classification.

Results

No re-revisions or radiographic failure was detected in the early follow-up period.

Conclusion

Impaction grafting into a mesh is an interesting treatment option to restore bone in combined cavitary and segmental defects.

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Disclosures

Conflict of Interest:

Johannes Buckup, MD and Emiliano Alvarez Salinas, MD have declared that they have no conflict of interest. Alejandro Gonzalez Della Valle, MD is a paid consultant for Orthosensor, outside the work. Friedrich Boettner, MD is a paid consultant for Smith and Nephew and Ortho Development, has received grant funding from Smith & Nephew, received payments from DJ Ortho for lectures including service on Speakers Bureaus and has patents with the Hospital for Special Surgery, outside the work.

Human/Animal Rights:

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5).

Informed Consent:

Informed consent was waived from all patients for being included in the study.

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Authors and Affiliations

  1. Adult Reconstruction & Joint Replacement Division, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA

    Johannes Buckup MD, Alejandro Gonzalez Della Valle MD & Friedrich Boettner MD

  2. Adult Reconstruction & Joint Replacement Division, Hospital Austral, Avenida Peron 1500, Pilar, Provincia de Buenos Aires, Argentina

    Emiliano Alvarez Salinas MD

Authors
  1. Johannes Buckup MD
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  2. Emiliano Alvarez Salinas MD
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  3. Alejandro Gonzalez Della Valle MD
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  4. Friedrich Boettner MD
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Corresponding author

Correspondence to Friedrich Boettner MD.

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Buckup, J., Salinas, E.A., Valle, A.G.D. et al. Treatment of Large Acetabular Defects: A Surgical Technique Utilizing Impaction Grafting into a Metallic Mesh. HSS Jrnl 9, 242–246 (2013). https://doi.org/10.1007/s11420-013-9350-z

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  • DOI: https://doi.org/10.1007/s11420-013-9350-z

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