Bone graft substitutes for acetabular reconstruction in revision total hip arthroplasty

Twenty revision arthroplasties were performed using the impaction grafting technique on the acetabular side. The morselized autogenous bone grafts were mixed with synthetical hydroxyapatite ceramic. Reinforcement acetabular rings were used to impact the mixed grafts. Current criteria were used for clinical and radiological assessment. The mean follow-up examination of the 20 hips was 5 years. The roentgenological analysis of the grafts showed fusion and a gradual condensation within 4 months after the index operation in all the hips, but one of them had evidence of some degree of bony resorption. One acetabular component failed because of malposition and was revised 6 months after the operation. The graft shoed in this case fusion at the host bone interface and osteointegration of the synthetical hydroxyapatite ceramic. The revision of the acetabular component with severe bony defect filled with a mix of synthetical hydroxyapatite ceramic and autologous bone grafts have proved to be of value in the mid-term follow-up.