title: Reconstruction of non-contained acetabular defects with impaction grafting, a reinforcement mesh and a cemented polyethylene acetabular component.
abstract: This review summarises the technique of impaction grafting with mesh augmentation for the treatment of uncontained acetabular defects in revision hip arthroplasty. The ideal acetabular revision should restore bone stock, use a small socket in the near-anatomic position, and provide durable fixation. Impaction bone grafting, which has been in use for over 40 years, offers the ability to achieve these goals in uncontained defects. The precepts of modern, revision impaction grafting are that the segmental or cavitary defects must be supported with a mesh; the contained cavity is filled with vigorously impacted morselised fresh-frozen allograft; and finally, acrylic cement is used to stabilise the graft and provide rigid, long-lasting fixation of the revised acetabular component. Favourable results have been published with this technique. While having its limitations, it is a viable option to address large acetabular defects in revision arthroplasty. Cite this article: Bone Joint J 2017;99-B(1 Supple A):25-30.
authors.affiliation: Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA.
authors.forename: B S
authors.initials: BS
authors.lastname: Waddell
authors.affiliation: Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA.
authors.forename: A Gonzalez
authors.initials: AG
authors.lastname: Della Valle
mesh_terms: D000077:Acetabulum / Q000601:surgery; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation* / Q000379:methods*; D001843:Bone Cements; D016025:Bone Transplantation / Q000379:methods*; D006621:Hip Joint / Q000000981:diagnostic imaging; D006622:Hip Prosthesis; D006801:Humans; D020959:Polyethylene; D011300:Preoperative Care / Q000379:methods; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation / Q000295:instrumentation / Q000379:methods; D013526:Surgical Mesh
chemical_list: D001843:Bone Cements; D020959:Polyethylene
keywords: Acetabulum; Impaction bone grafting; Revision