[Acetabular reconstruction in revision arthroplasty. Retrospective study of 76 cases. Hospital Español de México].
OBJECTIVE
To review our experience with the various acetabular reconstruction techniques used during revision arthroplasty based on the defect in each patient.


METHODS
We undertook a retrospective, descriptive, observational study of patients who underwent acetabular reconstruction during revision ar. throplasty, from January 1997 to January 2005. We documented the type of acetabular defect, the type of cup and graft used, the complications, and the pre- and postoperative assessment with the Harris scale. Data were analyzed with the SPSS software and the Wilcoxon test (p < 0.05).


RESULTS
Seventy-six patients underwent surgery. Mean time elapsed between the primary replacement and the revision was 5 years. The acetabular defects found were: 16 type I, 22 type II, 30 type IIIA, and 8 type IIIB. The mean Harris score was 44 preoperatively and 76 postoperatively. The most frequently used technique involved the use of an autograft, a structural allograft with a porous threaded cup or a reinforcement ring. The most common complications included dislocation 5%, infection 3%, graft loss and cup loosening 21%, and loss of the hip center of rotation 15% (p < 0.05).


CONCLUSIONS
Acetabular reconstruction is technically challenging and involves high failure and complication rates, thus providing little improvement in patient activity. It is important to restore the hip center of rotation to improve function. The reconstruction techniques we used are the most common ones and are described in the literature.
Trueba Davalillo
Cesáreo
C
Hospital Español de México, Granada, DF Mexico.
Gil Orbazo
Félix
F
Reyes Marco
Fernando
F
Minueza Mejía
Tomás
T
Navarrete Alvarez
José Mario
JM
D000077:Acetabulum / Q000473:pathology / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data*; D016025:Bone Transplantation / Q000706:statistics & numerical data; D005260:Female; D006617:Hip Dislocation / Q000453:epidemiology / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008800:Mexico; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000601:surgery; D011474:Prosthesis Design; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000453:epidemiology / Q000601:surgery; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000601:surgery; D016896:Treatment Outcome