Acetabular Revision Surgery in Major Bone Defects by Unknown

Author:Unknown
Language: eng
Format: epub
ISBN: 9783319985961
Publisher: Springer International Publishing

Conclusions and Recommendations

Bone impaction grafting is one of the few biological methods to really reconstruct the bone loss as is often seen in revision surgery. This is important, and especially in the younger patients facing a future revision. Unfortunately, we will be confronted with more revisions in younger patients [34]. The process of incorporation of impacted bone grafts has been studied both in animal experiments and in human biopsies, with nearly complete incorporation of these grafts demonstrated. Satisfactorily outcomes of acetabular bone impaction grafting for the management of cavitary and simple segmental defects in revision procedures have been reported in many studies. However, in the Paprosky type IIIA and IIIB defects there certainly is a need for improvement of the outcomes. There are some guidelines to improve the outcome. First, one should start to get familiar with bone impaction grafting in the smaller and less demanding defects before starting to reconstruct extensive defects. It is important, especially in the larger defects to use larger chips from 8 to 12 mm. There is a need to improve the quality of the meshes, certainly in the situation larger superolateral defects. The limitations of the technique are unclear about how extensive the reconstruction can be. A thickness to a maximum of 3 cm seems to be safe. However, even in the case of a failed bone impaction grafting, even in a large defect, often the next revision is more easy as there will be more bone then at the first revision.

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