Acetabular reconstruction in revision hip surgery using femoral head block allograft.
This prospective study analyzed the clinical and radiological results of 140 consecutive cases of acetabular revision using large frozen femoral head allografts and cemented all-polyethylene acetabular components. Mean follow-up was 10 years (range: 5-16 years). Thirty patients died, seven were lost to follow-up, and 26 had failed and undergone further surgery. Nineteen failures were due to aseptic failure and collapse of the graft. Kaplan-Meier survival analysis calculated a mean survival at 10 years of 88.5% for revision for any reason. We compared all reported techniques of acetabular reconstruction for similar defects and recommend a surgical strategy based on the available evidence, but weighted towards a preference to reconstitute bone stock rather than removing further bone in the revision situation.
Piriou
Philippe
P
Hôpital Raymond Poincaré, Garches, France.
Norton
Mark
M
Marmorat
Jean-Luc
JL
Judet
Thierry
T
D000077:Acetabulum / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D015897:Comorbidity; D018572:Disease-Free Survival; D005260:Female; D005270:Femur Head / Q000637:transplantation*; D005602:France / Q000453:epidemiology; D006622:Hip Prosthesis / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D011379:Prognosis; D019651:Plastic Surgery Procedures / Q000706:statistics & numerical data*; D020127:Recovery of Function; D012086:Reoperation / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D014184:Transplantation, Homologous / Q000706:statistics & numerical data; D016896:Treatment Outcome