Outcome of Total Hip Replacement Following Acetabular Defect Reconstruction / Ahmed Maher Mahmoud ; Supervised Ashraf AbdelKader Elnahal , Mohamed Saeed Abdelmaksood , Mohamed Ahmed Abdelmeniem

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Orthopaedic Surgery

Acetabular defect reconstruction presents a difficult challenge in hip arthroplasty, specifically when restoration of center of rotation and bone stock besides optimization of joint stability is considered . Various reconstruction techniques have been described but no consensus has been reached on the optimal method. The objective of this study was to review the outcome of different acetabular reconstructive techniques. Patients and Methods : A prospective study of 30 cases with acetabular defect reconstruction performed between 2018 and 2020 was conducted with 2-years follow-up. There were 18 (60%) males and 12(40%) females, the mean age of patients was 47.7+10.2years. Results The mean preoperative Harris hip score was 40.6, the mean postoperative Harris hip score was 88.5 at 1year. Six patients (20%) had the following complications: One patient (3.3%) had radiological signs of loosening, One patient (3.3%) developed deep venous thrombosis, Two patients (6.6) had sciatic nerve palsy and Two patients (6.6%) developed heterotrophic ossification.Discussion: Several types of grafts and implants have been used for acetabular bone defects such as impaction bone graft, structural bone allograft, mega cups, reinforcement rings and cages and more recently metal augments. All of them have proven their effectiveness when used correctly. Conclusion: Our study confirmed that restoration of center of rotation is crucial for satisfactory outcomes and longevity of the implant , furthermore acetabular bone defects reconstruction is technically demanding and requires adequate surgical experience

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