Acetabular Reconstruction with Reinforcement Ring and Morsellised Graft: Technique and Medium-term Result

Abstract

Background: Acetabular bone defects are commonly seen in both primary and secondary total hip arthroplasty, creating difficulties in restoring anatomical hip centres, which results in high mechanical failure rate. Methods: Total hip arthroplasty with acetabular reinforcement rings were performed in 18 hips in 18 patients from 1996 to 2011 in United Christian Hospital. Both clinical and radiographical assessment were performed during follow-up. Results: Eight patients died of unrelated diseases with average follow-up of 30.5 months. At the latest follow-up, none of them showed radiographic signs of loosening or migration of implants and none of them required revision surgery. The remaining 10 patients with mean age of 77.9 years (range, 65–88) at the time of operation were followed-up for an average of 67.4 months (range, 11–121). The average Harris hip score was 78.3 (range, 58.5–87). The average vertical and horizontal difference of hip centres was 1.5 mm superiorly (p = 0.431) and 0.4 mm medially (p = 0.619) respectively when postoperative hip centres were compared to their contralateral hips. The average inclination of the polyethylene cup was 47.8 degrees (range, 42–58). There was no evidence of radiographic loosening during our follow-up and none of them required revision surgery. Conclusion: Acetabular reconstruction with the use of acetabular reinforcement rings and morsellised bone grafts showed satisfactory clinical and radiographic results at a medium-term follow-up.

Keywords

• acetabular defects
• acetabular reinforcement ring
• bone graft
• total hip arthroplasty