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HYDROXYAPATITE IN REVISION OF TOTAL HIP REPLACEMENTS WITH MASSIVE ACETABULAR DEFECTS

4- TO 10-YEAR CLINICAL RESULTS

H. Oonishi, MD, Orthopaedic Surgeon and Vice-Director; Y. Iwaki, MD, Orthopaedic Surgeon; N. Kin, MD, Orthopaedic Surgeon; S. Kushitani, MD, Orthopaedic Surgeon; N. Murata, MD, Orthopaedic Surgeon; S. Wakitani, MD, Orthopaedic Surgeon; and K. Imoto, MD, Orthopaedic Surgeon

Department of Orthopaedic Surgery, Artificial Joint Section and Biomaterial Research Laboratory, Osaka-Minami National Hospital, 677-2, Kido-Cho, Kawachinagano-Shi, Osaka 586, Japan.

Correspondence should be sent to Dr H. Oonishi.

Hydroxyapatite (HA) granules of 100 to 300 µm, 0.9 to 1.2 mm and 3.0 to 5.0 mm were mixed in a ratio of 10:45:45 and packed into massive bone deficiencies in revision operations for total hip arthroplasty. We did not use additional graft or cup support for deficiencies of the lateral and medial wall. The procedure was carried out in 40 hips between 1986 and 1992.

The radiographic spaces seen at the interface between HA and bone immediately after surgery disappeared within three months. Some spaces appeared between HA granules near the bone in the lateral part of two joints, and three sockets migrated in patients with severe segmental and cavitary deficiencies. Direct bonding of HA to bone was observed radiologically without morphological changes, except in the three joints with migration. All patients could walk without pain but the three with definite loosening needed crutches.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General