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Current Issue - July 2025, Volume 19, Issue No. 2

Official Journal of Malaysian Orthopaedic Association and ASEAN Orthopaedic Association

Two-stage Acetabular Impaction Bone Grafting: A Case Report

Abstract

Restoring bone loss in revision Total Hip Arthroplasty (THA) surgery is challenging. Acetabular impaction bone grafting (AIBG) allows the restoration of bone stock and normal hip biomechanics. AIBG is usually performed as a single-stage surgery with hip component implantation, as it is traditionally believed that adequate loading of the impacted graft is necessary for integration with the host bone thus preventing bone resorption. We present a case of a 73-year-old gentleman who presented with bilateral hip pain and reduced mobility. He was diagnosed with left THA aseptic loosening with acetabular protrusion and subsequently underwent a two-stage AIBG using irradiated femoral head allografts. The first stage was performed without acetabular loading, yet the allograft successfully integrated with the host bone. This is the first reported case of a two-stage AIBG demonstrating that acetabular loading may not be required for allograft integration to host bone. Therefore, AIBG may be performed as a two-stage procedure, when necessary, especially in the setting of complex revision hip surgeries and patients with poor bone stock.

Abstract   |   Reference

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The Malaysian Orthopaedic Journal is a peer-reviewed journal that is published three times a year in both print and electronic online version. The purpose of this journal is to publish original research studies, evaluation of current practices and case reports in various subspecialties of orthopaedics and traumatology, as well as associated fields like basic science, biomedical engineering, rehabilitation medicine and nursing.

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