Benjamin Deheshi, MD
Ottawa, ON
Purpose
To evaluate outcome of curettage and grafting of progressive retroacetabular osteolysis with calcium sulfate pellets and retention of components.
Methods
We conducted a clinical and radiographic review of 7 patients who presented to the senior author with radiographic findings of progressive retroacetabular osteolysis. All patients were treated with curettage and filling of the defects with calcium sulfate in the form of pellets or putty.
Results
Mean follow-up time is 26 (11 - 40) months. Polyethylene wear was noted in all cases. The size of the lesions ranged from 3.1 x 2.0 to 9.0 x 5.3 cm. On follow-up evaluation, there was no recurrence or progression of the lesions. Osseo-integration was excellent in 4 cases and good in 3 cases. All patients had returned to normal level of function with no pain.
Discussion:
Patients with retroacetabular osteolysis are often asymptomatic until catastrophic failure occurs as a result of extensive bone loss. Treatment of retroacetabular osteolysis in the setting of well-fixed components is controversial. Retention of the components, curettage and synthetic grafting with calcium sulfate is a viable option to prevent progression of lysis and stimulate bone formation.