JUMBO CUPS AND MORSELIZED GRAFT

Revision of failed acetabular components presents a formidable problem due to associated loss of bone and sclerosis of the remaining bone. U ncemented acetabular components with porous surfaces have revolutioniz ed acetabular revision surgery. They can be stabilized into the existi ng host bone with supplemental screws even in the face of major bone l oss. Nonstructural particulate bone grafts can then be used to supplem ent the bone stock. With large defects, jumbo acetabular components ra nging in sizes from 70 to 80 millimeter outer diameters can be stabili zed on the acetabular rim while the defects can be grafted with morsal ized bone. Nineteen of such revisions performed for major bone loss wi thout pelvic discontinuity between February 1986 and December 1988 wer e evaluated at a mean follow-up period of ten years (range eight to el even years). One component had been revised for sepsis. None of the ot hers had been revised. Definite radiographic failure of fixation of th e acetabular component was not seen on any of the other hips. These re sults strongly support the use of jumbo uncemented acetabular componen ts with morsalized bone grafts even in the face of major acetabular bo ne loss.