Midterm Follow Up of Acetabular Reconstruction of Dysplastic Hips using Structural and/or Morselized Bone Graft in Primary Total Hip Arthroplasty

Document Type : Original Article

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Abstract

Background: Acetabular fixation is a dysplastic hip challenge, and many approaches for primary total hip arthroplasty (THA) have been shown. Even though each surgical procedure was discussed, combining bulk graft with impaction of morselized graft is promising. To confirm long-term outcomes, additional research into the clinical outcomes of a combined set of procedures may be necessary.
Objective : The aim of the current study is to report the midterm results of using structural and/or morselized autografts for acetabular reconstruction in a series of patients with developmental dysplasia of the hip (DDH).
Patients and methods: A total of 44 patients with 44 hips were included in the study. They were followed prospectively for an average period of 2-3 years. Preoperative planning was done including laboratory and radiological investigations. Harris Hip Score (HHS) was applied pre- and post-operatively.
Results: HHS was raised from 41.24 before surgery to 83.4 at the latest follow-up. The limb-length was restored to within 0.5 cm in 38 cases (86.4%). Only 4 patients (9.09%) had radiological signs of structural graft resorption. Two (4.5%) patients developed complete radiolucent lines and were revised for loosening. Infection complicated the post-operative course of 3 (6.8%) patients in this study.
Conclusion: The technique of biological acetabular reconstruction using structural and/or morselized bone graft in primary THA for cases of acetabular dysplasia is reliable, and it not only simplifies the attainment of initial stability, but also strengthens the mid-term to long-term stability during THA in DDH.
 

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The Egyptian Journal of Hospital Medicine
Volume 90, Issue 1
January 2023
Pages 1328-1333

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