Reconstruction of bone defect at the top of acetabulum during revision total hip arthroplasty with cup blocking screws and impaction bone grafting

Guan Mingqiang; Wei Jinqiang; Chen Weijian; Zhou Guanming

doi:10.12307/2026.051

Abstract：BACKGROUND:Bone defect at the top of acetabulum during revision total hip arthroplasty is a common and complex challenge,because it often affects the initial and mid-term to long-term stability of the acetabular cup during revision surgery. OBJECTIVE:To evaluate the effect of bone defect reconstruction at the top of acetabulum with cup blocking screws and impaction bone grafting during revision total hip arthroplasty. METHODS:Between March 2018 and December 2022,11 patients with acetabular cup loosening and acetabular top Paprosky ⅢA bone defect after total hip arthroplasty in Foshan Hospital of Traditional Chinese Medicine were selected.All patients were reconstructed with acetabular blocking screw combined with particle impaction bone grafting technology.Harris score,satisfaction score,and leg length discrepancy were recorded and compared before revision and at the final follow-up after revision.X-ray films were observed to evaluate the condition of acetabular cups and blocking screws. RESULTS AND CONCLUSION:(1)All 11 patients were followed up for 20-72 months.(2)Harris score,satisfaction score,and leg length discrepancy were significantly improved at the last follow-up(P<0.001).(3)Last postoperative X-ray films showed good bone ingrowth around the cup and no acetabular loosening in all patients.(4)No cup blocking screw was found to be broken or displaced in last postoperative X-ray films.(5)All these results imply that cup blocking screws combined with impaction particulate bone grafting is a simple and reliable technique in reconstructing the bone defect at the top of acetabulum during revision.This technique can not only simplify the achievement of initial stability during revision,but can also strengthen the mid-term to long-term stability of the cup.