Impaction Bone Grafting with Low Dose Irradiated Freeze‐Dried Allograft Bone for Acetabular Reconstruction |
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| Authors: | Hongxing Li Kelvin Guoping Tan Zhiling Li Xiaoxin Wu Guangping Cai Weihong Zhu Tianlong Huang Wanchun Wang Ross Crawford Xinzhan Mao |
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| Affiliation: | 1. Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha China ; 2. Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore ; 3. Center of Health Management, The Central Hospital of Shaoyang, Shaoyang China ; 4. Department of endocrinology, The Xiangya Hospital, Central South University, Changsha China ; 5. Department of Orthopedic, Prince Charles Hospital, Brisbane Queensland, Australia |
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| Abstract: | ObjectiveReconstruction of acetabular defects has been extremely challenging in both primary and revision total hip arthroplasty (THA). Impaction bone grafting (IBG) can restore the acetabulum bone mass and anatomically reconstruct the acetabulum. Our study aimed to report the short and medium‐term clinical and radiographic outcomes of IBG for acetabular reconstruction in the cemented THA in the Chinese population.MethodsThis was a single‐center retrospective review enrolling 57 patients between May 2013 and July 2019. The patients with acetabular defects were treated with IBG, using low dose irradiated freeze‐dried allograft bone with or without autograft bone, in the cemented THA performed by one senior surgeon. Harris hip score (HHS), standard pelvis anterior–posterior radiograph and lateral hip radiograph were obtained before operation and at 1 week, 3 months, 12 months, and yearly. Graft osteointegration was evaluated by Oswestry''s criteria, and complication was documented at the last follow‐up. Independent sample ANOVA test and Pearson chi‐square tests are used for statistical analysis.ResultsThere were 61 hips in 57 patients. The average follow‐up time was 35.59 months (5–77 months). According to AAOS classification, a total of 18 hips were identified as segmental bone deficiency (type I), with 21 and 22 hips for cavitary bone deficiency (type II) and the combined bone deficiency (type III), respectively. The average HHS was improved from 44.49 (range: 32–58) preoperatively to 86.98 (range: 78–93) postoperatively. Graft osteointegration was satisfactory (Oswestry score ≥2) in all patients. No dislocation occurred in the 57 patients (61 hips) during follow‐up. Although one cup migrated, no revision, re‐revision, radiographic loosening, graft bone lysis, or postoperative complications were detected at the final follow‐up.ConclusionsIBG with low‐dose irradiated freeze‐dried allograft bone in acetabular bone defect reconstruction is a reliable technique for restoring acetabular bone defects in THA. |
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| Keywords: | Acetabular bone defect, Acetabular reconstruction, Impaction bone grafting, Low dose irradiated freeze‐ dried allograft bone, Total hip arthroplasty |
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