The Use of Impaction Bone Grafting in Total Hip Arthroplasty Following Acetabular Fractures

Islam Nassar¹, Sameh Marei², Ahmad Zayda², Ahmed Zaki³ & Elsayed Morsi^4*

¹Specialist of Orthopedic Surgery, Department of Orthopedic Surgery, Faculty of Medicine, Alexandria University, Egypt
²Lecturer of Orthopedic Surgery, Department of Orthopedic Surgery, Faculty of Medicine, Menoufia University, Egypt
³Teaching Assistant of Analytical & Pharmaceutical Chemistry,Department of Analytical & Pharmaceutical Chemistry, Faculty of Pharmacy and Drug Manufacturing, Pharos University, Egypt
⁴Professor and Head of Orthopedic Surgery Department, Department of Orthopaedic Surgery, Menoufia University, Egypt

Dr. Elsayed Morsi, Professor and Head of orthopedic surgery Department, Department of Orthopaedic Surgery, Menoufia University, Egypt.

Keywords: Total Hip Arthroplasty; Fracture Acetabulum; Impaction Graft

Abstract

Purpose
Patients suffering from osteoarthritis of the acetabulum after acetabular fractures often require a total hip arthroplasty. Reconstruction of acetabular bone loss in these cases is challenging. The aim of this work was to evaluate the results of mid-term follow-up using impaction bone grafting (IBG) and a cemented cup.
Patients and Methods
This work included 43 patients with post-traumatic osteoarthritis of the acetabulum and bone loss after acetabular fractures. Two patients were lost to follow-up. The remaining 41 patients consisted of 15 males and 26 females. Mean age was 69 years. The right hip was affected in 21 patients, while the left hip in 20. All patients were treated by total hip arthroplasty using IBG technique, Kerboul ring, and a cemented cup. Patients were evaluated clinically using Harris hip score and radiologically. Mean follow up was 4.1 years (range 3-7).
Results
At an average 4.1 years follow up, there was 100% implant survivorship and no evident risk for revision. The mean postoperative Harris hip score was 92.1 (range 61-95). Bone graft was completely incorporated in the acetabulum in all cases. Two patients had Brooker type I heterotropic ossification.

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