Total Hip Arthroplasty with Acetabular Bone Graft Reconstruction in Neglected Fractures of the Acetabulum: A preliminary report of sixteen cases

Authors

  • Ayman Abdelaziz Bassiony Orthopedic Departement, Ain Shams University, Cairo, Egypt
  • Mohamed Kamal Asal Orthopedic Departement, Ain Shams University, Cairo, Egypt

DOI:

https://doi.org/10.12974/2313-0954.2016.03.01.5

Keywords:

Total Hip Arthroplasty-Acetabular fractures-Bone graft.

Abstract

Background: Neglected acetabular fractures is a challenging to treat. Total hip arthroplasty with bone-graft reconstruction is among the most popular methods of providing bony support in cases of acetabular bony deficiencies during total hip arthroplasty. Controversy still exists on the best method for bony reconstruction.

Patients and Methods: Sixteen patients having neglected acetabular fracture or fracture dislocation were operated for total hip arthroplasty using autograft from the femoral head. The average age of the patients was 50 years (range 36-58 years). There were 12 males and 4 females. Average time of follow up was 3 years.

Results: There was graft resorption in two cases with subsequent revision. Average Harris hip score pre-operatively was 46, which improved to an average of 84 post-operatively.

Conclusion: Our study has shown that total hip replacement with bone grafting in form of auto graft of the femoral head provide good results in reconstruction of acetabular bony deficiencies due to neglected acetabular fracture. 

References

Garrett JC, Epstein HC, Harris WH, Harvey JP Jr and Nickel VL. Treatment of unreduced traumatic posterior dislocations of the hip. J Bone Joint Surg Am 1979; 61: 2-6.

Matta JM. Fractures of the acetabulum: accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury. J Bone Joint Surg Am 1996; 78: 1632-45.

Schofer MD, Pressel T, Schmitt J, Heyse TJ and Boudriot U. Reconstruction of the acetabulum in THA using femoral head autografts in developmental dysplasia of the hip. J Orthop Surg Res 2011 Jun 22; 6: 32. http://dx.doi.org/10.1186/1749-799X-6-32

DeLee JG and Charnley J. Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res 1976; 20. http://dx.doi.org/10.1097/00003086-197611000-00003

Callaghan JJ, Salvati EA and Pellicci PM. Results of revision for mechanical failure after cemented total hip replacement, 1979 to 1982. A two to five-year follow-up. J Bone Joint Surg Am 1985; 67: 1074.

Brown EC and Kelley SS. Determination of the hip centre. In: Bono JV, McCarthy JC, Thornhill TS, et al, editors. Revision total hip arthroplasty. New York: Springer-Verlag 1999; p. 320. http://dx.doi.org/10.1007/978-1-4612-1406-9_47

Russotti GM and Harris WH. Proximal placement of the acetabular component in total hip arthroplasty. A long term follow-up study. J Bone Joint Surg Am 1991; 73:587.

Weeden SH and Schmidt RH. The use of tantalum porous metal implants for Paprosky 3A and 3B defects. J Arthroplasty 2007; 22(6 Suppl 2): 151. http://dx.doi.org/10.1016/j.arth.2007.04.024

Sporer SM and Paprosky WG. Acetabular revision using a trabecular metal acetabular component for severe acetabular bone loss associated with a pelvic discontinuity. J Arthroplasty 2006; 21(6 Suppl 2): 87. http://dx.doi.org/10.1016/j.arth.2006.05.015

Harris WH, Crothers O and Oh I. Total hip replacement and femoral-head bone-grafting for severe acetabular deficiency in adults. J Bone Joint Surg Am 1977; 59(6): 752-759.

Malkin C and Tauber C. Total hip arthroplasty and acetabular bone grafting for unreduced fracture-dislocation of the hip. Clin Orthop Relat Res 1985; 201: 57-9. http://dx.doi.org/10.1097/00003086-198512000-00009

Ilyas I and Rabbani SA. Total hip arthroplasty in chronic unreduced hip fracture-dislocation. J Arthroplasty 2009; 24: 903-8. http://dx.doi.org/10.1016/j.arth.2008.08.003

Hansen E, Shearer D and Ries MD. Does a cemented cage improve revision THA for severe acetabular defects? Clin Orthop Relat Res 2011; 469: 494-502. http://dx.doi.org/10.1007/s11999-010-1546-7

Mulroy RD Jr and Harris WH. Failure of acetabular autogenous grafts in total hip arthroplasty. Increasing incidence: a follow-up note. J Bone Joint Surg Am 1990; 72(10): 1536-1540.

Bellabarba C, Berger RA and Bentley CD. Cementless acetabular reconstruction after acetabular fracture. J Bone Joint Surg Am 2001; 83: 868-876.

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Published

2016-06-15

How to Cite

Bassiony, A. A., & Asal, M. K. (2016). Total Hip Arthroplasty with Acetabular Bone Graft Reconstruction in Neglected Fractures of the Acetabulum: A preliminary report of sixteen cases. International Journal of Orthopedics and Rehabilitation, 3(1), 30–34. https://doi.org/10.12974/2313-0954.2016.03.01.5

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