The Use And Analysis Of Morselized Bone Grafting In Revision Total Hip Arthroplasty With Bone Defect

Objective To investigate the use and analysis of morselized bone grafting in revision total hip arthroplasty with bone defectMethods During 2006.1 to 2008.9, in our hospital, morselized bone grafting was used in 26 cases (26hips) of revision total hip arthroplasty with bone defect of acetabulum by the same surgen.25 cases (25 hips) were followed-up with males of 8 cases and female of 16 cases.1 case have the bone defect of type I(AAOS),17 cases have the bone defect of typeⅡ(AAOS),7 cases have the bone defect of typeⅢ(AAOS). The average age is 60.9 years old (49-73 years), all of them are the first-time revision. Revision reasons are all aseptic loosening with bone defect. The average time to the first surgery is 10.5 years (0.3 years-18 years); The reason for the first surgery:10 cases are DDH,9 cases are avascular necrosis,2 cases are ankylosing spondylitis,2 cases are osteoarthritis,2 cases are femoral neck fracture.9 cases of the first surgery using biological prosthesis,15cases use cement-type prosthesis,1case use semi-hip replacement. At first, the combined defect was transformed in to cavitary defect with titanium mesh, then the contained acetabulum was tightly packed with allograft chips about 5mm, use particle suppress bone graft technology, econstruction of the hip normal anatomical configuration, restore bone mass.The content followed-up including many aspect, such as:(1) Function evaluated by Harris scores by telephone or on-site investigation; (2)Take X-rays of hips after 3 d,3 months, and every time the patient is follow-up.Results 25 patients (25 hips), was followed-up for average of 38.2months(24～52 months), the average Harris score before operation is 50.2 points (37-61 points) and the average Harris score after operation is 87.5 (75～97 points), excellent (> 90) in 10 cases, good (80～89) in 13cases, fair (70-79) in 2cases, no poor cases (< 70). The rate of excellent and good was 92%. no cup migration infection and fracture were found.Conclusion Using morselized bone grafting in revision total hip arthroplasty with serious bone defect is effective in short-term follow-up, But the final therapeutic effect couldn't be determined because of the lack long term and large amount of follow up study.