Background: There is an ever-increasing number
of failed hip arthroplasties associated with massive deficiency
of acetabular bone stock consisting of a segmental or cavitary defect.
This study was undertaken to evaluate the long-term results after
use of morselized cryopreserved allogeneic bone graft and an antiprotrusio
cage to treat such a deficiency.
Methods: From January 1, 1988, to January 1, 1994,
forty-one patients (forty-one hips) with an acetabular defect classified
as type III or IV according to the American Academy of Orthopaedic
Surgeons system were operated on with use of a Burch-Schneider ring
and morselized cryopreserved allogeneic cancellous bone graft. Thirty-eight
patients (thirty-eight hips) were available for clinical and radiographic
follow-up examinations at an average of 7.3 years (range, 4.2 to
9.4 years) after surgery.
Results: All measured clinical parameters had improved significantly
by the time of the follow-up examination (p < 0.0001).
Radiographs confirmed that none of the thirty-eight hips had any
measurable migration or displacement of the acetabular component and
that osseous consolidation occurred only within the grafted area
in all patients.
Conclusion: Acetabular reconstruction with use of
morselized cryopreserved allogeneic cancellous bone graft and the
Burch-Schneider ring can be highly successful in managing massive
acetabular deficiencies in revision hip arthroplasty.