title: Radiography versus multidetector computed tomography in assessing graft integration after acetabular reconstruction.
abstract: OBJECTIVE
  To compare radiography with multidetector computed tomography (MDCT) in the evaluation of graft integration following acetabular reconstruction for failed total hip arthroplasty (THA).
  
  
  METHODS
  Records of 5 men and 6 women aged 60 to 78 (mean, 71.8) years who underwent acetabular reconstruction using structural allografts for severe acetabular deficiency secondary to aseptic loosening (n=9) or septic loosening (n=2) were reviewed. The mean survival time of the THA was 136.4 (range, 12-360) months. Acetabular defects were classified as IIC (n=2), IIIA (n=3), or IIIB (n=6). Structural allografts were fixed with impaction followed by a reinforcement ring (n=10), an antiprotrusio cage (n=2), and/or an oblong cup (n=1) with gentamicineloaded cement. Cup loosening, graft integration, and graft resorption were evaluated using radiography. In addition, graft integration was evaluated using MDCT.
  
  
  RESULTS
  At a mean follow-up of 4.2 (range, 2-11) years, the survival of the acetabular reconstruction was 90.9%. No patient had any signs of infection. One patient underwent reoperation 22 months later for dislocation secondary to abductor deficiency caused by nonunion of the trochanteric fracture. According to radiography, all patients had graft integration. One patient had definitive and another had possible cup loosening. Four patients had minor graft resorption. According to MDCT, graft integration was complete in only one patient, partial >50% in 3, partial <50% in 4, and absent in 2.
  
  
  CONCLUSIONS
  MDCT is more accurate than radiography in evaluating graft integration following acetabular reconstruction.
authors.affiliation: Hip Unit, Department of Orthopaedic Surgery, Hospital Clínic, University of Barcelona, Spain.
authors.forename: Jenaro Ángel
authors.initials: JÁ
authors.lastname: Fernandez-Valencia
authors.forename: Xavier
authors.initials: X
authors.lastname: Gallart
authors.forename: Xavier
authors.initials: X
authors.lastname: Tomás
authors.forename: Daniel
authors.initials: D
authors.lastname: Piñeros
authors.forename: Sebastián
authors.initials: S
authors.lastname: García
authors.forename: Josep
authors.initials: J
authors.lastname: Riba
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000601:surgery*; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies
keywords: acetabulum; bone transplantation; multidetector computed tomography; reoperation