title: A comparison of acetabular impaction grafting and trabecular metal for revision arthroplasty.
abstract: BACKGROUND
  Acetabular defect reconstruction in revision hip arthroplasty may be achieved with acetabular impaction bone grafting (AIBG) or porous trabecular metal (TM) implantation. We sought to compare clinical and radiological outcomes of both methods at a single institution.
  
  
  METHODS
  36 patients that were revised using AIBG and 17 patients that were revised with TM were retrospectively reviewed from local joint registry data. 82% of the TM group and 64% of the AIBG group were ≥ Paprosky 2c. Rerevision was considered failure. Radiographs demonstrating 5 mm of migration of femoral head and 5° of acetabular component inclination change were considered loose.
  
  
  RESULTS
  Age at surgery was earlier in the AIBG group (median 68 years vs. 74 years). Median follow-up was 5.9 years for AIBG and 5.4 years for TM. Harris Hip Scores improved significantly for both groups (mean improvement: 32 vs. 31). There were 4 failures (11%) in the AIBG group and none in the TM group. 3 of the 4 AIBG failures occurred following second-stage revision for prosthetic joint infection. 4 (11%) and 2 (12%) hip reconstructions demonstrated radiological evidence of loosening in AIBG and TM groups respectively.
  
  
  CONCLUSIONS
  AIBG and TM acetabular defect reconstructions achieve good clinical outcome but there is greater success with TM in higher grades of acetabular deficiency regardless of prior infection.
authors.affiliation: Department of Trauma and Orthopaedic Surgery, University Hospital Limerick, Limerick - Ireland.
authors.forename: Fiachra E
authors.initials: FE
authors.lastname: Rowan
authors.affiliation: Department of Trauma and Orthopaedic Surgery, University Hospital Limerick, Limerick - Ireland.
authors.forename: Mike
authors.initials: M
authors.lastname: Gorenchtein
authors.affiliation: Department of Trauma and Orthopaedic Surgery, University Hospital Limerick, Limerick - Ireland.
authors.forename: Shoaib
authors.initials: S
authors.lastname: Aslam
authors.affiliation: Department of Trauma and Orthopaedic Surgery, University Hospital Limerick, Limerick - Ireland.
authors.forename: Finbarr
authors.initials: F
authors.lastname: Condon
authors.affiliation: Department of Trauma and Orthopaedic Surgery, University Hospital Limerick, Limerick - Ireland.
authors.forename: Eric L
authors.initials: EL
authors.lastname: Masterson
mesh_terms: D000077:Acetabulum / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D016025:Bone Transplantation; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D007592:Joint Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome