title: Massive bone defect compromises postoperative cup survivorship of acetabular revision hip arthroplasty with impaction bone grafting.
abstract: We evaluated 66 acetabular revision arthroplasties using cemented cup with impaction bone grafting (IBG) to detect the extent that bone defect affects the outcome. We defined the maximum acetabular defect distance (MADD), which indicates the greatest depth of the grafted layer. Cup survival analysis with aseptic loosening as the endpoint revealed that the "MADD≤20mm" group showed higher survivorship than the "MADD>20mm" group (95% vs. 74%, P=0.034), and that the simple-wall-defect group (none or one mesh used) showed higher survivorship than the complex-wall-defect group (two meshes used) (96% vs. 73%, P=0.044). A favorable indication for acetabular IBG reconstruction is cases in which those cups can be placed at≤20mm MADD with a simple wall defect.
authors.affiliation: Department of Orthopaedic Surgery, Hamamatsu Medical Center, Hamamatsu, Japan. Electronic address: tossy.iwase@gmail.com.
authors.forename: Toshiki
authors.initials: T
authors.lastname: Iwase
authors.affiliation: Department of Orthopaedic Surgery, Hamamatsu Medical Center, Hamamatsu, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Ito
authors.affiliation: Department of Orthopaedic Surgery, Hamamatsu Medical Center, Hamamatsu, Japan.
authors.forename: Daigo
authors.initials: D
authors.lastname: Morita
mesh_terms: D000077:Acetabulum / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D001862:Bone Resorption / Q000209:etiology / Q000601:surgery*; D016025:Bone Transplantation; D002484:Cementation; D005260:Female; D006621:Hip Joint / Q000000981:diagnostic imaging* / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D007592:Joint Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure / Q000209:etiology*; D011859:Radiography; D012086:Reoperation
keywords: acetabulum; allograft; impaction bone grafting; revision total hip arthroplasty; survival rate