Use of porous trabecular metal augments with impaction bone grafting in management of acetabular bone loss
Open Access
- 20 August 2012
- journal article
- clinical trial
- Published by Medical Journals Sweden AB in Acta Orthopaedica
- Vol. 83 (4), 347-352
- https://doi.org/10.3109/17453674.2012.718518
Abstract
The use of impaction grafting in revisions with larger acetabular bone defects has mixed outcomes and sometimes high failures rates. This prospective, single-center study involved a consecutive series of 24 patients who underwent complex reconstruction of the acetabulum using a trabecular metal augment, impaction bone grafting, and a cemented high-density polyethylene cup. Patients were followed for median 5 (3–7) years. The 2-year WOMAC pain, function, and stiffness scores improved, as did certain components (bodily pain, physical function, role physical, role emotional, physical component score, and social function) of the SF-36 (p < 0.05). 23 of the patients were very satisfied with the overall outcome of the surgery and would have undergone the surgery again for a similar problem, and 19 reported great improvement in their quality of life after surgery. Radiographs at the latest follow-up revealed incorporation of the augment with mean change in acetabular component inclination of less than 1 degree (p > 0.05) and cup migration of less than 5 mm in both horizontal and vertical axes (p > 0.05). 1 patient required further revision at 13 months and was found to have a fractured augment at re-revision. This study shows that trabecular metal augments are effective in filling the bone defect and provide a stable foundation for impaction bone grafting. We found satisfactory clinical and radiographic results using this technique, with low failure rate at a median follow-up time of 5 years.Keywords
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