Reconstruction of large defects of the roof of the hip joint using solid cortical spongy bone grafts.
Background. A favorable outcome following revision hip arthroplasty is the result of several factors. One of the basic conditions is stable fixation of the endoprosthetic acetabulum in the physiological site with full bone support. It is difficult to meet this condition, however, in cases of upward migration of the primary endoprosthetic acetabular graft. This requires the supplementation of defects of various sizes present within the roof of the acetabulum during the revision procedure.<br /> Material. The author presents long-term results from the reconstruction of the roof of the hip joint using solid corticalspongy bone grafts in 36 operated patients.<br /> Results. Features of graft healing and full bone remodeling were found within 12 months in 21 operated patients, in whom solid bony autografts taken from the iliac ala had been used to fill the defects. The healing process in 13 patients, in whom solid frozen grafts taken from the bone bank had been used for plastic reconstruction of the roof of the hip joint, lasted 22 months. Unfavorable bony graft healing was observed in 2 patients, in whom full osteolysis of the graft had occurred, resulting in loosening of the acetabulum. Both patients were administered high doses of Encorton due to rheumatoid arthritis in the pre- and post-operation period.
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katedra i Klinika Ortopedii i Traumatologii PAM, Szczecin.