Acetabular reconstruction with morcellized allograft and ring support - A medium-term review

Acetabular bone stock deficiency is commonly encountered in revision hip surgery. A number of techniques are available to address this problem, including the use of particulate allograft with reconstruction rings in an effort to provide a stable construct and replenish bone stock. Our technique and results using such devices in complex acetabular deficiencies are described. In the setting of a large medial segmental or cavitary acetabular defect, morcellized bone-graft is used to reconstitute the acetabular floor. This graft is reverse reamed until its depth allows screw fixation of a metallic support ring. The screws also serve to compress the graft. A polyethylene acetabular component is then cemented into the reconstituted acetabulum with full freedom of orientation. A series of 48 patients in whom this technique was employed is presented. These cases have been clinically and radiologically reviewed with a mean follow-up of 64 months (range, 25-102 months). Good bony incorporation with Stable acetabular components was seen in all but the two cases in which sepsis predominated.