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. 2009 Dec;33(6):1525-30.
doi: 10.1007/s00264-009-0722-4. Epub 2009 Feb 26.

Clinical and radiographic assessment of cementless acetabular revision with morsellised allografts

Chuang Sun  1 , Yong-Yun Lian, Yu-Hua Jin, Cheng-Bin Zhao, Shi-Qi Pan, Xue-Feng Liu
Affiliations

Clinical and radiographic assessment of cementless acetabular revision with morsellised allografts

Chuang Sun et al. Int Orthop. 2009 Dec.

Abstract
in English, French

The aim of this study was to evaluate the clinical and radiographic results of cementless acetabular revision with deep frozen morsellised allografts. Sixty-one patients (65 hips) underwent acetabular revision using cementless components and deep frozen morsellised allografts. Fifty-seven hips (53 patients) were reviewed at a mean of 105.1 months (range 72-180 months) after revision. The study group included 29 males and 24 females with a mean age of 46.4 years. One cup underwent further revision for aseptic loosening and two were defined as radiographic failures. The mean time for allograft incorporation was 12.5 months (range 6-24 months) after index surgery. The mean Harris hip score of the patients improved from 61.1 points preoperatively to 91.6 points postoperatively. Linear and cavitary osteolysis was observed in two and 12 hips, respectively. The acetabular revision using cementless components with deep frozen morsellized allografts provides favourable clinical and radiographic results, although the initial disease and age may adversely affect the outcomes.

L’objectif de cette étude est d’évaluer les résultats cliniques et radiographiques de la chirurgie de révision acétabulaire associant allogreffes morcelées, cryoconservées. Matériel et méthode : 61 patients (65 hanches) ont bénéficié d’une reprise avec cupule sans ciment et allogreffes morcelées cryoconservées. 57 hanches (53 patients) ont été revues en moyenne à 105,1 mois (de 72 à 180 mois) après la révision. Ce groupe comprend 29 hommes et 24 femmes avec un âge moyen de 46,4 ans. Résultats : une cupule a nécessité une nouvelle reprise pour un descellement aseptique et 2 ont été cataloguées comme échec sur le plan radiographique. Le temps moyen de l’incorporation de l’allogreffe a été de 12,5 mois (entre 6 et 24 mois), le score moyen de Harris de ces patients s’est amélioré de 61,1 points en préopératoire à 91,6 points en postopératoire. Des ostéolyses linéaires et cavitaires ont été observées respectivement sur 2 et 12 hanches. Conclusions : la technique de révision acétabulaire utilisant un composant non cimenté avec des greffes morcellées cryoconservées permet d’obtenir des résultats cliniques et radiographiques fiables néanmoins, la pathologie initiale et l’âge des patients peuvent avoir des effets négatifs sur l’évolution.

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Figures

Fig. 1
Fig. 1
Radiograph made before revision of the hip of a 57-year-old woman who underwent acetabular revision demonstrating loosening of the acetabular component with creation of combined defect (AAOS Type-III)
Fig. 2
Fig. 2
Radiograph of the hip of a 57-year-old woman who underwent acetabular revision made six months after acetabular cup revision with deep frozen morsellised allograft and a hemispherical cementless acetabular cup
Fig. 3
Fig. 3
Radiograph of the hip of a 57-year-old woman who underwent acetabular revision, made 144 months postoperatively, showing the incorporation and remodelling of transplanted morselised allograft, with no signs of radiolucency, and the cup was well fixed
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