Acetabular bone defect in total hip revision surgery with allograft punched bone graft combined with titanium mesh cup reconstruction…

  Objective: To investigate the method and effect of using allograft compression implants combined with titanium mesh cups to reconstruct acetabular bone defects in total hip revision surgery.  Methods: From January 2009 to December 2013, a total of 20 patients with acetabular bone defects in total hip revision using allogeneic granular compression implants combined with titanium mesh cups were applied, including 5 males and 15 females; the average age at the time of revision was 64.8 years. Using Paprosky’s typing, the types of bone defects in this group of patients were 3 cases of type 2A, 12 cases of type 2B, 5 cases of type 2C, and 2 cases of type 3B.  After removal of the loose acetabular lateral prosthesis, deep autoclaved allogeneic frozen bone processed by autoclaving was prepared into 7-10 mm cancellous bone particles, and the bone volume was restored using the beating technique, and then titanium mesh cups of appropriate radius were selected, and the metal mesh was attached and fixed to the bony structures around the acetabulum using more than 3 screws, and then the appropriate diameter polyethylene socket cups were selected and fixed using bone cement to reconstruct the normal anatomical form of the hip joint. The clinical results were evaluated using the Harris hip scoring system.  Pelvic radiographs and hip orthopsies were taken 1 week after surgery, 3, 6, 9 and 12 months after surgery, and then annually for radiographic evaluation.  Results: All patients were followed up after surgery with a mean follow-up of 3.07 years (1 to 6 years). The mean preoperative Harris score was 44 (17-67) and the mean postoperative Harris score was 85.3 (67-97) in this group (P<0.05< span="">). No cases with displacement of the socket cup >4 mm or rotation >5° were found at the final follow-up, and no significant cemented translucent zone changes were observed. One postoperative case had symptoms of impaired sciatic nerve traction, which gradually recovered after 3 months; there were no cases of infection or dislocation in this group.  Conclusion: The use of allogeneic granular compression bone graft combined with titanium mesh cup to repair acetabular bone defect and the use of cemented socket cup for artificial total hip revision has a simple surgical method, can effectively reconstruct the center of rotation of the hip joint, promote the integration of the bone graft area, prevent the socket cup from being displaced again, has good economy, and can obtain good near- to mid-term results.