The outcomes of acetabular impaction bone grafting using allografts in uncemented cups for acetabular bone loss: a systematic review and meta-analysis.
Reece Patel, Khalil Saadeh, Owain Bates et al.
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In 30 seconds
This systematic review and meta-analysis assessed clinical and functional outcomes of allograft impaction bone grafting with uncemented cups for acetabular bone loss in total hip arthroplasty. It included 20 observational studies covering 1166 THAs in 1122 patients. The pooled mean Harris Hip Score improved by 41.51 (95% CI: 35.71-47.30). Pooled rates were 7% for aseptic loosening, 4% for infection, 9% for revision, and 4% for mortality. The authors noted considerable heterogeneity and limitations in the underlying evidence.
Key findings
- Mean Harris Hip Score improved by 41.51 (95% CI: 35.71-47.30).
- Pooled aseptic loosening was 7% (95% CI: 4%-13%), and infection was 4% (95% CI: 3%-5%).
- Pooled need for revision was 9% (95% CI: 6%-14%); mortality was 4% (95% CI: 2%-11%).
- Results showed considerable heterogeneity across studies.
Why it matters
Acetabular bone loss complicates total hip arthroplasty, particularly revision procedures. These pooled findings suggest that impaction bone grafting with uncemented cups can be associated with functional improvement and provide estimates of reported complications. However, variation between studies and the observational evidence base mean the results should be interpreted cautiously rather than as definitive comparative evidence.
What to keep in mind
All included studies were observational; the authors report risk of bias, considerable heterogeneity, and lack of stratification by defect.