抄録
The authors report four cases of revision hip arthroplasty with massive deficiency of acetabular bone (AAOS classification, type 3). Autograft, allograft and A-W glass ceramics were grafted in the area of bone deficiency, and the Kerboull cross shell was implanted to reconstruct the acetabulum in each case. All four hips were type 3 according to the American Academy Orthopaedic Surgeons' classification. The revision arthroplasties were performed in our hospital from 1995 through 2000.
The patient in the first case was an 88 year-old woman. In 1984, she was performed the left THA in our hospital. In 1998, left coxalgia recurred and the abnormal sound of the joint occurred. The range of motion of left hip joint was extremely limited.
The patient in the second case was a 75 year-old woman. In 1978, she was performed the left THA. In 1995, left coxalgia recurred. Because she had suffered from osteoarthritis of right hip joint too, she was performed a right THA in advance. Autograft from that operation was used in left revision arthroplaty.
The patient in the third case was a 79 year-old woman. In 1985, she was performed the left THA in our hospital. In 1999, left coxalgia recurred, and infection was recognized and all implants were removed. After the infection improved, we performed a left revision arthroplasty.
The patient in the fourth case was an 82 year-old woman. In 1987, she was performed the right THA in our hospital. In 2000, right coxalgia recurred. Inner head was dislocated from acetabulum.
In all of our cases, coxalgia disappeared and there is no loosening although clinical course is still short term.