Acetabular revision with impacted morsellised cancellous bone grafting and a cemented acetabular component: A 20- TO 25-YEAR FOLLOW-UP

• Published in: Journal of bone and joint surgery. British volume Vol. 91; no. 9; pp. 1148 - 1153
• Main Authors: SCHREURS, B. W, KEURENTJES, J. C, GARDENIERS, J. W. M, VERDONSCHOT, N, SLOOFF, T. J. J. H, VETH, R. P. H
• Format: Journal Article
• Language: English
• Published: London British Editorial Society of Bone and Joint Surgery 01.09.2009
• Subjects: Acetabulum - diagnostic imaging; Acetabulum - surgery; Adult; Aged; Aged, 80 and over; Arthroplasty, Replacement, Hip - methods; Biological and medical sciences; Bone Transplantation - methods; Diseases of the osteoarticular system; Epidemiologic Methods; Equipment Failure Analysis; Female; Hip Prosthesis - adverse effects; Humans; Male; Medical sciences; Middle Aged; Orthopedic surgery; Osteoarthritis, Hip - diagnostic imaging; Osteoarthritis, Hip - surgery; Radiography; Reoperation - statistics & numerical data; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Young Adult; Reoperation; Acetabulum; Orthopedic surgery; Treatment; Bone graft; Cement
• ISSN: 0301-620X; 2044-5377
• DOI: 10.1302/0301-620X.91B9.21750

We present an update of the clinical and radiological results of 62 consecutive acetabular revisions using impacted morsellised cancellous bone grafts and a cemented acetabular component in 58 patients, at a mean follow-up of 22.2 years (20 to 25). The Kaplan-Meier survivorship for the acetabular component with revision for any reason as the endpoint was 75% at 20 years (95% confidence interval (CI) 62 to 88) when 16 hips were at risk. Excluding two revisions for septic loosening at three and six years, the survivorship at 20 years was 79% (95% CI 67 to 93). With further exclusions of one revision of a well-fixed acetabular component after 12 years during a femoral revision and two after 17 years for wear of the acetabular component, the survivorship for aseptic loosening was 87% at 20 years (95% CI 76 to 97). At the final review 14 of the 16 surviving hips had radiographs available. There was one additional case of radiological loosening and four acetabular reconstructions showed progressive radiolucent lines in one or two zones. Acetabular revision using impacted large morsellised bone chips (0.5 cm to 1 cm in diameter) and a cemented acetabular component remains a reliable technique for reconstruction, even when assessed at more than 20 years after surgery.