ACETABULAR AND FEMORAL RECONSTRUCTION WITH IMPACTED GRAFT AND CEMENT

Loosening of primary cemented and noncemented components of total hip arthroplasties always is accompanied by a loss of bone stock, There ar e several options for reconstruction of the acetabular and femoral def ects, The authors' treatment of choice is a standardized cemented revi sion procedure with tight impaction of morsellized cancellous autograf t or allograft chips in acetabular and femoral reconstructions, In thi s study, the clinical and radiographic evaluation of acetabular defect s reconstructed with impacted morsellized allograft femoral heads was described, A cemented cup supplemented with morsellized cancellous gra fts and wire meshes in cases of segmental defects was sufficiently sta ble to allow for complete graft consolidation, After a mean followup o f 70 months of 88 hips, 4 cases of clinical failures (including 1 infe ction) and 6 cases of radiologic failure of the reconstructions were o bserved, resulting in a failure percentage of 11.4% after 5 years, Aut ografts and allografts were equally effective, Because the clinical su ccess of the technique also was supported by the results of histologic and biomechanic studies in animals, the authors were encouraged to co ntinue this technique, not only in the acetabulum, but also in the fem ur.