title: Acetabular reconstruction with impaction bone grafting and cemented polyethylene socket in total hip revision arthroplasty.
abstract: OBJECTIVE
  Bone deficiency in revision total hip arthroplasty is a challenge to the surgeon. One option for restoration of the bone stock is impaction bone grafting and use of a cemented socket. The aim of this study was to evaluate the mid-term clinical outcome of impaction bone grafting and cemented socket revisions.
  
  
  METHODS
  A total of 59 patients (60 hips) underwent revision arthroplasty with impaction bone grafting and application of a cemented socket on the acetabular side in the Turku University Hospital from 1999 to 2004. The study end-point was re-revision for any reason. The cumulative percentages for survival were followed and estimated with Kaplan-Meier curves. Associations between occurrence of re-revision and potential risk factors were analyzed with logistic regression. Results were quantified by odd ratios and 95% confidence intervals. The mean age of the patients was 69 years (33% male). A total of 3% of the patients had a class I Paprosky acetabular defect, 38% had class II, and 55% had class III.
  
  
  RESULTS
  The overall survival rate was 73%. The mean follow-up time was 7 years. The most common reason for re-revision was aseptic loosening of the acetabular component (13 patients, 81% of re-revisions). Cox's regression analysis did not identify any risk factors for re-revision.
  
  
  CONCLUSIONS
  Our results were inferior compared to some previous studies. Impaction bone grafting of acetabular defects in revision total hip arthroplasty may not always provide a reliable bone stock in long-term.
authors: Department of Orthopaedics and Traumatology, Turku University Hospital, Turku, Finland inkost@utu.fi inari.kostensalo@fimnet.fi.
authors: I
authors: I
authors: Kostensalo
authors: Department of Orthopaedics and Traumatology, Turku University Hospital, Turku, Finland.
authors: M
authors: M
authors: Seppänen
authors: Department of Orthopaedics and Traumatology, Turku University Hospital, Turku, Finland.
authors: P
authors: P
authors: Virolainen
authors: Department of Orthopaedics and Traumatology, Turku University Hospital, Turku, Finland.
authors: J
authors: J
authors: Mokka
authors: Department of Biostatistics, University of Turku, Turku, Finland.
authors: M
authors: M
authors: Koivisto
authors: Department of Orthopaedics and Traumatology, Turku University Hospital, Turku, Finland.
authors: K T
authors: KT
authors: Mäkelä
mesh_terms: D000077:Acetabulum / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000401:mortality; D001843:Bone Cements; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery*; D020959:Polyethylene; D011183:Postoperative Complications; D011474:Prosthesis Design; D011475:Prosthesis Failure; D019651:Plastic Surgery Procedures / Q000379:methods*; D012086:Reoperation; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome
chemical_list: D001843:Bone Cements; D020959:Polyethylene
keywords: Impaction bone grafting; acetabular reconstruction; revision hip arthroplasty