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Treatment of large acetabular defects: a surgical technique utilizing impaction grafting into a metallic mesh.


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.

SUBMITTER: Buckup J 

PROVIDER: S-EPMC3772160 | biostudies-literature | 2013 Oct

REPOSITORIES: biostudies-literature

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Publications

Treatment of large acetabular defects: a surgical technique utilizing impaction grafting into a metallic mesh.

Buckup Johannes J   Salinas Emiliano Alvarez EA   Valle Alejandro Gonzalez Della AG   Boettner Friedrich F  

HSS journal : the musculoskeletal journal of Hospital for Special Surgery 20130815 3


<h4>Background</h4>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.<h4>Description of technique</h  ...[more]

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