Management of retro-acetabular osteolysis with a retained shell and injection of demineralized bone matrix using a vinyl urinary catheter and syringe: a simple technique and case series
摘要
The management of retro-acetabular osteolysis in revision hip arthroplasty with acetabular component retention remains controversial and challenging due to limited access to the area.
Surgical technique and methodsFourteen patients with well-fixed and well-aligned acetabular components underwent revision surgery and a retained shell. A vinyl urinary catheter and syringe were used to deliver demineralized bone matrix putty to the bone defect after debridement. Clinical outcome and radiographic follow-up were scheduled at a minimum of 2 years.
ResultsThe revision arthroplasty survivorship rate with this technique was 85.7% (12 of 14 patients) at a median follow-up of 6 years. One cup failed due to an aseptically loosening cup, and another from late septic loosening. Significant improvement of the University of California Los Angeles (UCLA) score, Harris Hip Score (HHS) pain subscale, and Hip Disability and Osteoarthritis Outcome Score for Joint Replacement (HOOS JR) were observed at a median 6-year follow-up.
ConclusionsManagement of retro-acetabular osteolysis with injected demineralized bone matrix using a syringe and vinyl urinary catheter is a reliable, easy, low-cost method with satisfactory mid-term clinical outcome improvement.
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