Background: Total Hip Arthroplasty (THA) is one of many therapies given to hip joint injury patients. The main indication for THA in elderly patients is degenerative diseases of the joints. One of the difficulties encountered in this THA procedure is to overcome the acetabulum deficiency, with Paprosky Classification. This study aims to evaluate patients with acetabulum defect that have undergone THA at Dr. Soetomo Hospital in 2014-2016. Methods: This was an observational retrospective study with descriptive analysis. The sample amount was 20 patients, from 80 patients who had THA procedure. Patients were evaluated based on the wear from acetabulum, migration from a cup, the presence of bone loss, heterotopic ossification, and also clinical condition based on Harris Hip Score. The presented results were analyzed by using Kruskal-Wallis on SPSS 19.0 for Windows Program. Results: Hypothesis testing was performed on THA patients based on acetabulum defect type I, II, and III in one, two, and three years after surgery respectively. Massin Score resulted no differences with p = 0.156, p = 0.574, and p = 0223. Bone Loss Classification resulted no differences with p = 0.296, p = 0.287, and p = 0223. No difference on Wear Rate with p = 0.072, p = 0.110, and p = 0.325. There was no difference of Harris Hip Score with p = 0.320, p = 0.082, and p = 0.472. Conclusion: There were no significant differences in radiological evaluation of the Migration Rate, Heterotopic Ossification or Bone Loss, Wear Rate, and on clinical evaluation of Harris Hip Score in all three groups of evaluated acetabulum defects.

Background: limb deformity, especially lower leg deformity is a common case in orthopaedic practice. Limb deformity can be classified according to cause (Congenital, developmental, post trauma), geometry (angulation, rotation, shortening), severity and progression. In severe and complex deformity, the treatment choice is gradual correction using Ilizarov system. Benefit of the gradual correction using Ilizarov system are: (1) reduce the risk of neurovascular injury, (2) minimal soft tissue disturbance, (3) multiplanar and multidirectional correction.Cases: We have performed 11 deformity correction using ilizarov device during january 2013- September 2017. Evaluation data was obtained retrospectively from medical record. Nine patients were managed by Ilizarov device for bone lengthening indication and 2 patients for bone transport indication. The treatment result was evaluated using ASAMI scoring system for bone condition and functional condition.Results: Elevent patients were managed by Ilizarov system for gradual deformity correction. Nine patients already finished the treatment and the frame was removed. We cannot evaluate two patients because the correction was not finished. The ilizarov device was changed with other fixation because implant failure during correction phase. Evaluation using ASAMI score showed good bone score result for 9 patients and 7 excellent results for functional score.Conclusion: Ilizarov system has a promising result to correct lower limb deformity patients in Dr Soetomo General Hospital.

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Bone allograft serves as an alternative to overcome the limitation of autograft. Some concerns, such as graft rejection, infection, and low union rate, arise from the use of bone allograft since the graft is a non-living and foreign material. We reported a case of critical-sized bone defect in a skeletally immature patient treated with massive intercalary allograft that not only did it show union but also graft incorporation that allowed for subsequent bone lengthening at the site of the incorporated massive allograft. To our knowledge, there has been a report of lengthening of free-vascularized fibular autograft but not the nonvascularized one. Massive intercalary allograft that incorporates well to the host could be an option to treat criticalsized bone defect.