Innovative Approach to Large Acetabular Bone Loss in Young Patients: Midterm Outcomes of Bone Impaction Grafting with Trabecular Metal Reconstruction | ||
| The Egyptian Orthopaedic Journal | ||
| Articles in Press, Accepted Manuscript, Available Online from 07 August 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/eoj.2025.399556.1058 | ||
| Authors | ||
| Mahmoud MI Abd Ghafar* 1; Hany EA Elashmawy2; Mohmmed Mohsen Elkabbani3 | ||
| 1orthopedic department, faculty of medicine Mansoura university | ||
| 2Orthopedic Surgery Department, Faculty of Medicine, Mansoura University | ||
| 3Assistant professor of the orthopedic department, faculty of medicine, Mansoura University | ||
| Abstract | ||
| Abstract Background: Revision of total hip arthroplasty (THA) in young patients with extensive acetabular bone loss poses a significant challenge due to high rates of graft collapse and implant failure. This study evaluates the mid-term clinical and radiological outcomes of combining trabecular metal (TM) augments with impacted morselized allograft in patients aged ≤ 55 years with defects involving more than 50% of the acetabular cavity. Methods: This single-center, retrospective cohort study included 25 patients who underwent revision. Clinical outcomes (Harris Hip Score [HHS], Visual Analog Scale, and SF-36) and radiographic parameters (horizontal and vertical component displacement, cup abduction angle, graft incorporation, and radiolucent lines) were assessed (mean follow-up 5.2 ± 1.3 years). The Kaplan-Meier analysis was used to estimate the implant survival rate. Results: Postoperative assessment revealed significant anatomic and functional restoration, with improvements in horizontal and vertical component displacements and cup abduction angle (p < 0.05). At the same time, Harris Hip Scores, VAS pain scores, and SF-36 quality-of-life indices increased markedly (p < 0.01). Radiographically, over 90% of hips achieved complete graft incorporation, with only one case (4%) showing loosening. Kaplan–Meier survival at 5 years was 92%. Complications were minimal, and graft incorporation showed a moderate correlation with functional improvement (r = 0.45, p = 0.03). Conclusions: The hybrid technique of TM augments plus impaction bone grafting restores acetabular anatomy, achieves high rates of biological integration, delivers excellent mid-term implant survival, and significantly improves functional outcomes in young patients with severe acetabular defects. | ||
| Keywords | ||
| Revision Total Hip Arthroplasty; Acetabular Bone Loss; Bone Impaction Grafting; Trabecular Metal Augments; Osteointegration | ||
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