title: Favorable survival of acetabular reconstruction with bone impaction grafting in dysplastic hips.
abstract: Acetabular bone loss hampers implantation of a total hip arthroplasty in patients with developmental dysplasia of the hip. The bone impaction grafting technique in combination with a cemented total hip can restore the bone stock in these patients, but do these reconstructions yield satisfying long-term results? We used this technique in 28 hips (22 consecutive patients). The degree of dislocation was graded preoperatively as Crowe I in five hips, Crowe II in eight hips, Crowe III in nine hips, and Crowe IV in four hips. We present the long-term results of this bone impaction grafting technique a minimum of 10 years after surgery. Two patients died before the minimum followup of 10 years, leaving 20 patients (26 hips). Two cups were revised, one cup for a sciatic nerve palsy (at 2 years) and the other for aseptic loosening after 12 years. The cumulative survival of the cup with revision for any reason as the end point was 96% at 10 years and 84% at 15 years. There were no femoral revisions during followup. The bone impaction grafting technique in combination with a cemented cup is an effective technique for developmental dysplasia of the hip with favorable long-term results.
  
  
  METHODS
  Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
authors.affiliation: Department of Orthopaedics, Radboud University Nijmegen Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
authors.forename: Matthijs P
authors.initials: MP
authors.lastname: Somford
authors.forename: Stefan B T
authors.initials: SB
authors.lastname: Bolder
authors.forename: Jean W M
authors.initials: JW
authors.lastname: Gardeniers
authors.forename: Tom J J H
authors.initials: TJ
authors.lastname: Slooff
authors.forename: B Willem
authors.initials: BW
authors.lastname: Schreurs
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000601:surgery*; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D016025:Bone Transplantation; D005260:Female; D005500:Follow-Up Studies; D006618:Hip Dislocation, Congenital / Q000000981:diagnostic imaging / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011475:Prosthesis Failure; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome