Acetabular reconstruction using fresh frozen bone allograft.

The success of total hip arthroplasty has led to a move toward operating on a wider and younger population. All implants have a finite useful life, and bone loss is associated with all major causes of failure. The use bone allograft, either morselized or structural has the aim of reconstituting the bone stock. We retrospectively reviewed the clinical and radiological results of 72 acetabular reconstructions both primary and revision, done at our institute between May 1999 and October 2004 with a minimum follow-up of one year. The Harris Hip Score (HHS) was calculated and follow-up radiographs were evaluated for graft incorporation; evidence of loosening and migration. Preoperatively 28 acetabular defects were type III (AAOS), 18 were type II, 16 were type I and 10 were type IV. 60 reconstructions were done using cementless acetabular prostheses, and the remaining twelve had cemented implants. Patients were followed up for an average of 30.69 months (range 12 - 64 months). The mean preoperative HHS was 36.13 points which improved to a mean of 81.6 points (range 61 to 91) at final follow-up. None of the patients required reoperation. Dislocation was the commonest complication (8 hips). Short and medium term results were encouraging with the use of this technique.