Jumbo cups and morselized graft

Revision of failed acetabular components presents a formidable problem due to associated loss of bone and sclerosis of the remaining bone. Uncemented acetabular components with porous surfaces have revolutionized acetabular revision surgery. They can be stabilized into the existing host bone with supplemental screws even in the face of major bone loss. Nonstructural particulate bone grafts can then be used to supplement the bone stock. With large defects, jumbo acetabular components ranging in sizes from 70 to 80 millimeter outer diameters can be stabilized on the acetabular rim while the defects can be grafted with morsalized bone. Nineteen of such revisions performed for major bone loss without pelvic discontinuity between February 1986 and December 1988 were evaluated at a mean follow-up period of ten years (range eight to eleven years). One component had been revised for sepsis. None of the others had been revised. Definite radiographic failure of fixation of the acetabular component was not seen on any of the other hips. These results strongly support the use of jumbo uncemented acetabular components with morsalized bone grafts even in the face of major acetabular bone loss.