Allograft reconstruction of the acetabulum in revision hip surgery.
Acetabular deficiencies seen in revision hip arthroplasty require special attention.  Custom components, space-filling cement, relocation of the hip center higher on ilium, and resection arthroplasties have all been used.  Allograft reconstruction of acetabular defects has many attractive features, but methods of fixation, long-term success rates, and problems of graft resorption and implant loosening present significant questions. This article presents a classification system for acetabular defects and a surgical technique for correcting them.  The results of 218 cementless acetabular reconstructions are reviewed and show the importance of the acetabular rim.  When the rim is intact, 97% of reconstructions will remain stable, and 78% of allografts used will consolidate.  When the acetabular rim is deficient, special techniques using bulk allograft and internal fixation must be used in order to avoid long-term graft resorption and implant loosening.
Washington Sports Medicine and Orthopaedic Associates, Kirkland, WA.
C M
CM
McAllister
L S
LS
Borden
D000077:Acetabulum / Q000601:surgery*; D001843:Bone Cements; D016025:Bone Transplantation / Q000379:methods*; D005069:Evaluation Studies as Topic; D006622:Hip Prosthesis / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D016916:Joint Deformities, Acquired / Q000145:classification*; D012086:Reoperation / Q000295:instrumentation / Q000379:methods; D014184:Transplantation, Homologous