Bone Remodeling in Acetabular Reconstruction Using a Kerboull-Type Reinforcement Device and Structural Bone-Grafting in Total Hip Arthroplasty.
The purpose of this study was to identify the long-term durability of the Kerboull-type reinforcement device (KT plate) in acetabular reconstruction for massive bone defects, assessing the remodeling of structural bone grafts.



This study retrospectively evaluated 106 hips that underwent acetabular reconstruction using a KT plate between November 2000 and December 2010. Thirty-eight primary total hip arthoplasties (THAs) and 68 revised THAs were performed, and the mean duration of clinical follow-up was 8 years (5-14 years). Regarding reconstructing the acetabular bone defects, autografts were used in 37 hips, allografts in 68 hips, and A-W glass ceramics in 2 hips.



One hip exhibited radiological migration and no revision for aseptic loosening. The mean Merle d'Aubigné Clinical Score improved from 7.5 points (4-12 points) preoperatively to 10.9 points (9-18 points) at the last follow-up. The Kaplan-Meier survival rate for radiological migration of primary and revised THAs at 10 years was 100% and 97% (95% confidence interval: 96%-100%), respectively. Bone remodeling was evaluated using the radiological demarcation at the bone-to-bone interface, and an improvement of 100% in primary THAs and 94% in revised THAs was observed.



For massive bone defects, acetabular reconstruction using the KT plate with a structural bone grafting can yield successful results.
Department of Orthopaedic Surgery, Kansai Medical University, Hirakata, Osaka, Japan.
Kenichi
K
Oe
Department of Orthopaedic Surgery, Kansai Medical University, Hirakata, Osaka, Japan.
Hirokazu
H
Iida
Department of Orthopaedic Surgery, Kansai Medical University, Hirakata, Osaka, Japan.
Kohei
K
Tsuda
Department of Orthopaedic Surgery, Kansai Medical University, Hirakata, Osaka, Japan.
Tomohisa
T
Nakamura
Department of Orthopaedic Surgery, Kansai Medical University, Hirakata, Osaka, Japan.
Naofumi
N
Okamoto
Department of Orthopaedic Surgery, Kansai Medical University, Hirakata, Osaka, Japan.
Yusuke
Y
Ueda
D000077:Acetabulum / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation* / Q000379:methods; D064592:Autografts; D001860:Bone Plates; D016723:Bone Remodeling; D016025:Bone Transplantation / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D016896:Treatment Outcome
Kerboull-type reinforcement device; acetabular reconstruction; bone remodeling; radiological demarcation; structural bone graft