Impacted bone graft combined with structural bone graft for the reconstruction of acetabular bone defects in adult developmental dysplasia of hip

Abstract:

Objective：To explore the clinical effects of impacted bone graft combined with structural bone graft for the reconstruction of acetabular bone defects in adult developmental dysplasia of hip（DDH）. Methods：Totally 11 adult patients suffered from DDH were treated in our hospital from January 2007 to June 2012. According to Crowe classification，there were 5 cases of type Ⅱ and 6 cases of type Ⅲ dysplasia，respectively. All acetabular bone defects were type Ⅲ defects（combined defects） according to the American Academy of Orthopaedic Surgeons classification. Femoral head allograft and femoral head autograft were used in structural bone graft for 3 cases and 8 cases，restpectively. All defects were further treated with autologous bone acquired from the femur or ilium using impacted morselized bone grafting technique. Results：Patients were followed up for 6-48 months，with no complications such as infection，hip pain and cup loosening being observed. Average Harris hip score increased from 39.7（18-52） before the surgery to 85.7（52-96） at the last follow-up. Conclusions：Structural bone graft and appropriate cup can provide instant support for the acetabular bone defects，while impacted bone graft can promote the fusion of acetabular cup with surrounding bone.