Augmentation for Acetabular Deficiencies in Complex Total Hip Arthroplasty

Introduction: Complex and revision Total Hip Arthroplasty (THA) is a challenging prospect in patients with acetabular bone deficiencies. Augmentation using allograft and trabecular metal (TM) are among some of the options in these situations. This study report the outcomes of 14 cases of complex and revision THA using acetabular augments performed in our institution between 2015 and 2018 Materials and Methods: In this retrospective study, data included demographic features, indication for THA, type of augments and clinical outcomes using the Harris hip score were collected for the to determine early results following THA. Results: The mean cohort age was 51.3 years. Gender distribution was equal with 7 male and female patients each. 7 THAs were augmented with allograft and 7 cases with TM augments. The average duration of follow-up was 16.9 months. Most patients (11 of 14) required complex primary THA following prior traumatic hip dislocations and its subsequent complications. The mean post-operative Harris hip score for functionality was 80.84 in our cohort at final follow-up (from an average of 33.8 pre-operatively). At present, there have been no reports of wound complications, infections or dislocations in this early cohort. Discussions: Complex/revision THA using allografts for acetabular augmentation have been used for decades with good and replicable results as shown in our series. TM is relatively new but current literatures show encouraging results. Both options have resulted in good outcomes in our cohort and further long term studies would be necessary before TM augments were to replace the need for allograft. Conclusions: Both allografts and TM acetabular augments showed good early results post-operatively in our cohort. With the improved flexibility of component selection and the lower risk of allograft infection, TM augments is currently our choice of acetabular augmentation and the early results are promising.