Iatrogenic Paprosky type 2 C acetabular defect, reconstruction by metal mesh, femoral head bulk allograft and a cemented cup, A case report

Abstract

Introduction: Acetabular bone defect encountered during complex primary or revision total hip arthroplasty (THA) could be reconstructed using various options. Case presentation: We present a male patient, 36 years old, presented with an iatrogenic acetabular defect, Paprosky type 2C; reconstructed using metal mesh, femoral head bulk allograft, and a cemented cup. After proper exposure, a fresh frozen femoral head allograft was prepared to produce a monobloc graft shell of four mm thickness which was impacted inside a metal mesh adapted according to the acetabulum size, the graft-mesh unit was impacted inside the acetabulum to reconstruct the medial defect, and a cemented cup was placed. After three years, the patient obtained an excellent functional outcome according to Harris Hip Score. The radiograph showed maintenance of implant position and hip center of rotation restoration. Conclusion: Acetabular defect reconstruction using bone graft, metal mesh, and a cemented cup restored the hip center of rotation with an excellent functional outcome.

Keywords

• Bulk graft
• Acetabular bone defect
• Revision hip arthroplasty
• Metal mesh
• Cemented cup