Results and outcome predictors after revision surgery for severe acetabular bone defects

INTRODUCTION The aim of this study was to assess results of different revision techniques for large acetabular bone defects identifying possible outcome predictors of the surgery. METHODS This retrospective study was carried out on 33 consecutive patients (22 females, 11 males) who underwent acetabular revision at our Institution for Paprosky grade II B and III (GIR 3or 4) acetabular bone defects. The average age at surgery was 67.1 years (range, 42 to 86). Burch-Schneider reinforcement cage and a cemented cup was used in 25 cases , trabecular metal revision shell in 6 cases, and LOR cup in 2 cases. The mean time between primary and revision procedure was 9.1 years and the mean follow-up was 48 months (range, 14 to 112). The Harris Hip Score (HHS) was obtained preoperatively and at latest follow-up. Pain at follow-up was evaluated using a 10-cm Visual Analog Scale (VAS). In 27 patients a follow-up radiographic evaluation was also performed. Determinants of HHS score at follow-up were assessed by linear regression analysis, using age, sex, BMI, rate of comorbidity (FCI), use of reinforcement ring, and time elapsed from the primary surgery as explanatory variables. RESULTS The average preoperative and follow-up HHS score was 41 ± 16 and 79 ± 13, respectively (p