title: Treatment of large acetabular defects: a surgical technique utilizing impaction grafting into a metallic mesh.
abstract: BACKGROUND
  Revision total hip arthroplasty in cases with severe acetabular bone loss is challenging. In the presence of combined cavitary and segmental defects without superior acetabular coverage, reconstructions with a structural acetabular allograft protected by a cage or a custom-made triflange cage have been the treatment of choice. The current paper describes an impaction grafting into a mesh for uncontained defects in revision total hip arthroplasty.
  
  
  METHODS
  After restoring containment with a mesh fixed with small fragment screws, defects were restored using impaction grafting combined with a cemented all-polyethylene cup.
  
  
  METHODS
  Fourteen consecutive acetabular impaction graftings were performed by two surgeons. All patients had a type 3B defect according to the Paprosky classification.
  
  
  RESULTS
  No re-revisions or radiographic failure was detected in the early follow-up period.
  
  
  CONCLUSIONS
  Impaction grafting into a mesh is an interesting treatment option to restore bone in combined cavitary and segmental defects.
authors.affiliation: Adult Reconstruction & Joint Replacement Division, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.
authors.forename: Johannes
authors.initials: J
authors.lastname: Buckup
authors.affiliation: Adult Reconstruction & Joint Replacement Division, Hospital Austral, Avenida Peron 1500, Pilar, Provincia de Buenos Aires Argentina.
authors.forename: Emiliano Alvarez
authors.initials: EA
authors.lastname: Salinas
authors.affiliation: Adult Reconstruction & Joint Replacement Division, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.
authors.forename: Alejandro Gonzalez Della
authors.initials: AG
authors.lastname: Valle
authors.affiliation: Adult Reconstruction & Joint Replacement Division, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.
authors.forename: Friedrich
authors.initials: F
authors.lastname: Boettner
keywords: acetabular bone loss; allograft; impaction grafting; metal mesh; revision total hip arthroplasty