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Cavitary acetabular defects treated with morselized cancellous bone graft and cementless cups

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Abstract

The use of impacted morselized cancellous bone grafts in conjunction with cementless hemispherical acetabular cups for treatment of AAOS type II acetabular cavitary deficiencies was evaluated in a retrospective study of 23 primary and 24 revision total hip arthroplasties, at a mean follow-up of 7.9 and 8.1 years, respectively. All primary hips received autografts, while all revision hips received allografts. Modified Harris Hip Scores for primary and revision hip replacements increased from a pre-operative mean of 37 and 47 to a postoperative mean of 90 and 86, respectively. All 23 autografts and 23 out of 24 cancellous allografts were radiographically incorporated without evidence of resorption. There were no instances of infection, component migration, or cases requiring subsequent acetabular revision. We conclude that impacted morselized cancellous bone-graft augmentation of cementless cups is a viable surgical option for AAOS type II cavitary acetabular defects.

Résumé

L’utilisation de greffes impactées morcelées en adjuvant d’une cupule non cimentée hémisphérique dans le traitement des pertes de substances osseuses acétabulaires de type AAOS II a été évaluée lors d’une étude rétrospective portant sur 23 prothèses primaires et 24 prothèses de révision avec un suivi moyen de 7.9 ans et 8.1 ans. Toutes les prothèses primaires ont été traitées par auto greffes alors que les révisions ont été traitées par allogreffes. Le score de Harris modifié pour les prothèses primaires et pour les révisions a été respectivement en préopératoire de 37 et 47 et s’est amélioré en postopératoire à 90 et 86. Les 23 auto greffes et les 23 sur 24 allogreffes ont été incorporées radiologiquement sans résorption. Il n’y a pas eu d’infection, pas de migration de la cupule, aucune révision acétabulaire. Nous pouvons conclure que la greffe impactée morcelée en conjonction avec la mise en place d’une cupule sans ciment est une procédure chirurgicale fiable pour le traitement des pertes de substances osseuses cavitaires de type AAOS II.

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Acknowledgements

The authors are grateful for the contributions of Larry Specht, MD, William L. Jaffe, MD, and Joseph D. Zuckerman, MD.

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  1. Musculoskeletal Research Center, NYU Hospital for Joint Diseases, New York University School of Medicine, 301 East 17th Street, New York, NY, 10003, USA

    G. C. T. Pereira, E. N. Kubiak, B. Levine, F. S. Chen & P. E. Di Cesare

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  1. G. C. T. Pereira
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  2. E. N. Kubiak
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  3. B. Levine
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  4. F. S. Chen
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  5. P. E. Di Cesare
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Correspondence to P. E. Di Cesare.

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Pereira, G.C.T., Kubiak, E.N., Levine, B. et al. Cavitary acetabular defects treated with morselized cancellous bone graft and cementless cups. International Orthopaedics (SICO 31, 445–450 (2007). https://doi.org/10.1007/s00264-006-0220-x

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  • DOI: https://doi.org/10.1007/s00264-006-0220-x

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