2007, Number 4
Acta Ortop Mex 2007; 21 (4)
García JJD, Bravo BPA, García HA, Dávila SOD, Correa DG
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ABSTRACTObjective: To describe the clinical and X-ray outcomes of the use of structured bone autograft and uncemented extended-configuration acetabular cup in hip revision surgery. Material and methods: Eighteen patients, 12 females (66.66%) and 6 males (33.33%), with a diagnosis of uncemented, aseptic acetabular loosening were assessed during the preoperative period, radiologically with the Paprowsky classification and clinically with the Harris scale. They were considered for revision surgery and exchange of the acetabular component with a structured autograft and an extended-configuration, uncemented acetabular cup. They were reviewed during the period from January 2000 to June 2005. Results: Mean follow-up was 48 months; according to the Paprowsky scale the acetabular deficiency was: grade I in 11 patients (61.11%), grade II in 5 patients (27.77%), and grade III in 2 patients (11.11%). The following uncemented cups were used: the Healy Flanged in 4 patients (22.22%), and the extended diameter cup in 14 patients (77.77%). The mean time to the assessment of radiological grafting was 14 weeks; the time to assisted weight bearing with a walker was 8 weeks, the time to full weight bearing with a walker was 10 weeks. Conclusion: The use of a structured autograft assures the integration and reinforcement of the acetabular bottom with a considerable length of time to healing of 8 to 12 weeks. The use of revision extended-configuration implants and their three-point fixation assures primary and secondary stability and helps the patient resume his activities.