Reconstruction of Acetabular and Femoral Bone Defects With Impaction Bone Grafting in Revision Hip Arthroplasty: A Case Report

Abstract

Background. For many years, the main reasons for revision surgeries after hip arthroplasty remain aseptic loosening and osteolysis, which lead to formation of bone defects of various size and localization. Given the relatively young age of patients undergoing revision, the methods of biological restoration of the bone tissue, such as impaction bone grafting (IBG), are of particular interest. Aim of the report to demonstrate the delayed outcome of impaction bone grafting using compacted morselized bone allograft. Case presentation. Complicated clinical case of a 62-year-old patient with Paprosky type IIA bone deficiency in the acetabulum and Paprosky type II bone deficiency in the proximal femur with aseptic loosening of the acetabular and femoral components of the hip prosthesis is presented. During revision arthroplasty with cemented components, IBG of the acetabulum and femur was performed with a reconstructive mesh augmentation of the acetabulum using Stryker X-Change technology. Bone allograft prepared with the use of heat disinfection method served as an osteoplastic material. Follow-up period was 4 years. Control X-rays demonstrate restoration of the center of rotation of the hip, presence of bone masses in the areas of pelvic and femoral bone defects, absence of osteoplastic material resorption and migration of implants during the follow-up period. Clinical assessment shows an improvement of the Harris Hip Score from 34 to 85 points. Conclusion. Obtained results showed the efficacy of impaction bone grafting with the bone allograft prepared with the use of heat disinfection method in the mid-term period.

Keywords

• impaction bone grafting
• revision hip arthroplasty
• bone defect
• bone allograft
• osteoplastic material