2007, Number 4
Acta Ortop Mex 2007; 21 (4)
Acetabular reconstruction in revision arthroplasty. Retrospective study of 76 cases. Hospital Español de Mexico
Trueba DC, Gil OF, Reyes MF, Minueza MT, Navarrete ÁJM
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ABSTRACTObjective: To review our experience with the various acetabular reconstruction techniques used during revision arthroplasty based on the defect in each patient. Material and methods: We undertook a retrospective, descriptive, observational study of patients who underwent acetabular reconstruction during revision arthroplasty, from January 1997 to January 2005. We documented the type of acetabular defect, the type of cup and graft used, the complications, and the pre- and postoperative assessment with the Harris scale. Data were analyzed with the SPSS software and the Wilcoxon test (p ‹ 0.05). Results: Seventy-six patients underwent surgery. Mean time elapsed between the primary replacement and the revision was 5 years. The acetabular defects found were: 16 type I, 22 type II, 30 type IIIA, and 8 type IIIB. The mean Harris score was 44 preoperatively and 76 postoperatively. The most frequently used technique involved the use of an autograft, a structural allograft with a porous threaded cup or a reinforcement ring. The most common complications included dislocation 5%, infection 3%, graft loss and cup loosening 21%, and loss of the hip center of rotation 15% (p ‹ 0.05). Conclusions: Acetabular reconstruction is technically challenging and involves high failure and complication rates, thus providing little improvement in patient activity. It is important to restore the hip center of rotation to improve function. The reconstruction techniques we used are the most common ones and are described in the literature.