A series of 43 acetabular revisions treated with impacted allograft bone and a roof reinforcement ring were reviewed. The average follow-up was 5 years (2–15). The mean age was 70 years. The position of the hip center, and the orientation of the ring and cup were digitized and measured. The average inclination of the roof ring with respect to the horizontal was 44° (22°-60°) early post-operatively. The cup inclination was 33° (21°- 49°). These figures did not change significantly at the latest follow-up. Definite loosening was defined as migration of the components or breakage of the screws. Four components were definitely loose. Two other patients had continuous radiolucent lines, but no migration of the components at the bone-implant interface. The radiographic success rate was 86%. Pre- and post-operative Harris Hip Score were 34.1 (18 - 65) and 71.6 (36 - 90) respectively. The study supports the use of impacted morsellized allograft bone and a roof reinforcement ring for cavitary acetabular defects.
CallaghanJ.J.. Results of revision for mechanical failure after cemented THR - Analysis of recent cases with 2–5 years follow-up. J Bone Joint Surg [Am]1985; 67-A: 1074.
2.
KavanaghB.F., IlstrupM.S., FitzgeraldR.H.. Revision total hip arthroplasty. J Bone Joint Surg [Am]1985; 67-A: 517.
3.
PellicciP.M., WilsonP.D., SledgeC.B.. Revision total hip arthroplasty. Clin Orthop1982; 170: 34.
4.
RautV.V., SineyP.D., WroblewskiB.M.. Revision of the acetabular component of a total hip arthroplasty with cement in young patients without rheumatoid arthritis. J Bone Joint Surg [Am]1996; 78-A: 1853–6.
5.
AvciS., ConnorsN., PettyW.. Two to ten year follow-up study of acetabular revisions using allograft bone to repair bone defects. J Arthroplasty1998; 13: 61–9.
6.
AzumaT., YasudaH., OkagakiK., SakaiK.. Compressed allograft chips for acetabular reconstruction in revision hip arthroplasty. J Bone Joint Surg [Br]1994; 76-B: 740–4.
7.
ConveryF.R., M-C M, DevineS.D., MeyersM.H.. Acetabular augmentation in primary and revision total hip arthroplasty with cementless prostheses. Clin Orthop1990; 252: 167–75.
8.
DorrL., WanZ.. Ten years of experience with porous acetabular components for revision surgery. Clin Orthop1995; 319: 191–200.
GarbuzD., MorsiE., MohamedN., GrossA.E.. Classification and reconstruction in revision acetabular arthroplasty with bone stock deficiency. Clin Orthop1996; 323: 98–107.
11.
GrossA.E., LavoieM.V., McdermottP., MarksP.. The use of allograft bone in revision of total hip arthroplasty. Clin Orthop1985; 197: 115–22.
12.
GrossA.E., DuncanC.P., GarbuzD., MorsiE.. Revision arthroplasty of the acetabulum in association with loss of bone stock. J Bone Joint Surg [Am]1998; 80-A: 440–51.
13.
PadgettD., KullL., RosenbergA., SumnerD.R., GalanteG.O.. Revision of the acetabular component without cement after total hip arthroplasty. J Bone Joint Surg [Am]1993; 75-A: 663–73.
14.
PaproskyW.G., MagnusR.E.. Principles of bone grafting in revision total hip arthroplasty. Clin Orthop1994; 298: 147–55.
15.
SilvertonC.D., RosenbergA.G., SheinkopM.B., KullL.R., GalanteJ.O.. Revision of the acetabular component without cement after total hip arthroplasty: a follow-up note regarding results at 7 to 11 years. J Bone Joint Surg [Am]1996; 78-A: 1366–70.
16.
JastyM.. Jumbo cups and morselized graft. Orthop Clin North Am1998; 29: 249–5.
17.
PaproskyW.G., PeronaP.G., LawrenceJ.M.. Acetabular defect classification and surgical reconstruction in revision arthroplasty: A six year follow-up evaluation. J Arthroplasty1994; 9: 33–44.
18.
McCollumD.E., NunleyJ.A., HarrelsonJ.M.. Bone-grafting in total hip replacement for acetabular protrusion. J Bone and Joint Surg [Am]1980; 62-A: 1065–73.
SlooffT.J., Van HornJ., LemmensA., HuiskesR.. Bone grafting for total hip replacement for acetabular protrusion. Acta Orthop Scand1984; 55: 593.
21.
SlooffT.J.J., BumaP., SchreursB.W., SchimmelJ.W., HuiskesR.. Acetabular and femoral reconstruction with impacted graft and cement. Clin Orthop1996; 323: 108–15.
22.
SchreursB.W., SlooffT.J.J., BumaP., GardeniersJ.W.M., HuiskesR.. Acetabular reconstruction with impacted morsellised cancellous bone graft and cement: a 10-to 15- year follow-up of 60 revisions. J Bone Joint Surg [Br]1998; 80-B: 391–5.
23.
RossonJ., SchatzkerJ.. The use of reinforcement rings to reconstruct deficient acetabula. J Bone Joint Surg [Br]1992; 74-B: 716–20.
24.
BerryD., MullerM.E.. Revision arthroplasty using an anti-protrusio cage for massive acetabular bone deficiency. J Bone Joint Surg [Br]1992; 74-B: 711–5.
25.
SamuelsonK.M., FreemanM.A.R., LevakB., RassmussenG.L., RevellP.A.. Homograft bone in revision acetabular arthroplasty: a clinical and radiographical study. J Bone Joint Surg [Br]1988; 70-B: 367–72.
26.
CabanelaM.E.. Reconstruction rings and bone graft in total hip revision surgery. Orthop Clin North Am1998; 29: 255–62.
27.
ZehntnerM.K., GanzR.. Midterm results (5.5–10 years) of acetabular allograft reconstruction with the acetabular reinforcement ring during total hip revision. J Arthroplasty1994; 9: 469–79.
28.
PetersC.L., CurtainM., SamuelsonK.M.. Acetabular revision with the Burch-Schnieder antiprotrusio cage and cancellous allograft bone. J Arthroplasty1995; 10: 307–12.
29.
HaentjensP., de BoeckH., HandelbergF., CasteleynP., OpdecanP.. Cemented acetabular reconstruction with the Müller support ring - a minimum five- year clinical and roentgenographic follow-up study. Clin Orthop1993; 290: 225–35.
30.
D'AntonioJ.A., CapelloW.N., BordenL.S.. Classification and management of acetabular abnormalities in total hip arthroplasty. Clin Orthop1989; 243: 126–37.
31.
FawcettK.J., BarrH.R.. Tissue banking. In: Americian Association of blood banks.Arlington, VA, 1987: 97–107.
32.
MoweJ.C.. Standards for tissue banking.Americian Association of Tissue Banks, Arlington, VA, 1984.
33.
SlooffT.J., BumaB., SchimmelJ.W., SchreursB.W., GardeniersJ.. Impaction grafting and cemented acetabular revision. In: VillarR.N., GrossA.E. eds. Revision hip arthroplasty: A practical approach to bone stock loss:Butterworth-Heinemann, 1997: 116–30.
34.
HeekinR.D., EnghC.A., VinhT.. Morselized allograft in acetabular reconstruction: A post mortem retrieval analysis. Clin Orthop1995; 319: 184–90.
SchimmelJ.W., BumaP., VersleyenD., HuiskesR., SlooffT.J.J.. Acetabular reconstruction with impacted morselized cancellous allografts in cemented hip arthroplasty. A histological and biomechanical study on the goat. J Arthroplasty1998; 13: 438–48.
37.
HirstP., EsserM., MurphyJ.C.M., HardingeK.. Bone grafting for protrusio acetabuli during total hip replacement. J Bone Joint Surg [Br]1987; 69-B: 229–33.
38.
OakeshottR.D., MorganD.A.F., ZukorD.J., RudanJ.F., BrooksP.J.. Revision total hip arthroplasty with osseous allograft reconstruction. Clin Orthop1987; 225: 37–61.
