Selvaratnam V, Leong V J, Gunainthran S, Chopra S, Kassim A F
National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Department of Orthopaedic Surgery, Universiti Malaya, Kuala Lumpur, Malaysia.
Department of Orthopaedic Surgery, Hospital Sultanah Bahiyah, Alor Setar, Malaysia.
Malays Orthop J. 2025 Jul;19(2):117-120. doi: 10.5704/MOJ.2507.015.
Restoring bone loss in revision Total Hip Arthroplasty (THA) surgery is challenging. Acetabular impaction bone grafting (AIBG) allows the restoration of bone stock and normal hip biomechanics. AIBG is usually performed as a single-stage surgery with hip component implantation, as it is traditionally believed that adequate loading of the impacted graft is necessary for integration with the host bone thus preventing bone resorption. We present a case of a 73-year-old gentleman who presented with bilateral hip pain and reduced mobility. He was diagnosed with left THA aseptic loosening with acetabular protrusion and subsequently underwent a two-stage AIBG using irradiated femoral head allografts. The first stage was performed without acetabular loading, yet the allograft successfully integrated with the host bone. This is the first reported case of a two-stage AIBG demonstrating that acetabular loading may not be required for allograft integration to host bone. Therefore, AIBG may be performed as a two-stage procedure, when necessary, especially in the setting of complex revision hip surgeries and patients with poor bone stock.
在翻修全髋关节置换术（THA）中恢复骨质流失具有挑战性。髋臼打压植骨（AIBG）可恢复骨量并恢复正常的髋关节生物力学。AIBG通常作为一期手术与髋关节假体植入同时进行，因为传统上认为，打压植骨充分负重对于与宿主骨融合从而防止骨吸收是必要的。我们报告一例73岁男性患者，其出现双侧髋关节疼痛且活动度降低。他被诊断为左THA无菌性松动伴髋臼突出，随后使用辐照股骨头异体骨进行了两期AIBG。第一期手术未进行髋臼负重，但异体骨成功与宿主骨融合。这是首例报告的两期AIBG病例，表明异体骨与宿主骨融合可能并不需要髋臼负重。因此，必要时AIBG可作为两期手术进行，尤其是在复杂的髋关节翻修手术以及骨量差的患者中。
