Abstract

BUTTARO, Martín et al. Copas de metal trabecular y aloinjertos óseos impactados en defectos acetabulares graves: Resultados a los 2-4 años. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2014, vol.79, n.2, pp.82-91. ISSN 1852-7434.

Background: Although trabecular metal cups have been widely used with excellent survival rates at short to intermediate term follow-up, the literature combining these devices with impacted bone allografts is scarce. We evaluated early results of trabecular metal components and bone reconstruction with impaction grafting techniques in acetabular revisions associated with major bone loss. We also compared these results with our previous procedures using reconstruction rings and impaction grafting in similar bone deficiencies. Methods: Twenty cases presenting Paprosky type 3A or 3B mechanical or septic defects in 19 patients with an average age of 65 years were prospectively followed. The preoperative functional score according to Merle D'Aubigne scale was 6.2 points. All the cases were reconstructed with impacted bone allografts and trabecular metal cups. Results: At an average follow-up of 30 months (range 24-48), the survival rate of the acetabular component was 95% (CI = 75-98%). One patient treated with a two staged protocol presented a septic failure 16 weeks after reimplantation and he was treated with a resection arthroplasty. The average postoperative functional score was 16.2 points. Bone allograft incorporation was observed in all cases, except the infected failure. The comparison with the historic controls using reconstruction rings was highly favorable for the trabecular metal cups. Conclusions: Impaction allografting and trabecular metal cups are a valid alternative in acetabular revision surgery presenting severe bone defects. This method is associated with better results compared to the previously obtained with bone allograft and reconstruction rings.

Keywords : Revision surgery; Severe bone defects; Bone allografts; Trabecular metal.

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