ACETABULAR REVISION USING A BONE-INGROWTH TOTAL HIP COMPONENT IN PATIENTS WHO HAVE ACETABULAR BONE STOCK DEFICIENCY

The clinical and radiologic results of acetabular revision using a por ous titanium-mesh metal-backed acetabular component fixed to the pelvi s with screws were studied in 30 consecutive patients 132 hips) who ha d moderate or severe acetabular bone loss. All of the acetabula were c lassified as type III or IV according to the American Association of O rthopaedic Surgeons' acetabular grading system. Particulate autologous or allogenic bone-graft was used in 75% of the reconstructions. The m ean follow-up period was 69 months (range, 46-109 months). Three aceta bular components (9%) were rerevised for aseptic loosening at an avera ge of 64 months, including one patient who had a primary diagnosis of radiation necrosis of the ilium. The average Harris hip score for the remaining 29 hips rose from 46 to 81. The radiologic failure rate was 3% (1 of 29 unrevised hips) for a total failure rate of 12%. No pelvic osteolysis was seen with this implant. Revision of acetabula that hav e moderate or severe bone deficiency by a bone-ingrowth acetabular com ponent fixed with screws and bone-graft appears to be successful in re storing bone stock and providing a stable, pain-free reconstruction.