A Three-dimensional Method for Evaluating Changes in Acetabular Osteolytic Lesions in Response to Treatment

Egawa, Hiroshi; Ho, Henry; Huynh, Cathy; Hopper, Robert H.; Engh, Charles A.

doi:10.1007/s11999-009-1050-0

Cited by 13 publications

(7 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Using cancellous bone chips, we achieved an average fill of 44% (range 13%-100%) of 15 treated osteolytic lesions. These results are similar to those reported by Egawa et al [21], who found an average fill of 49% (range 0%-83%) of 18 treated lesions during liner exchange. That study used the bone-graft substitute, calcium sulfate.…”

Section: Discussionsupporting

confidence: 92%

“…In a similar study, Egawa et al [21] used preoperative and post-operative CT scans in ten patients to develop a technique for quantifying new bone mineralisation. Using a bone graft substitute, calcium sulphate, as a defect filler, it was found that an average of 24% of the original lesion volume showed evidence of new mineralisation into the void left behind once the defect filler was resorbed, and that the amount of new mineralisation at one year follow-up was directly proportional to the amount of lesion filling achieved at revision [21]. This technique supports our results, which found that lesions showing good graft incorporation tended to have a greater percentage of the lesion filled by bone-graft.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Cemented Liner Exchange With Bone Grafting Halts the Progression of Periacetabular Osteolysis

Stamenkov

Neale

Kane

et al. 2014

The Journal of Arthroplasty

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Cemented Liner Exchange With Bone Grafting Halts the Progression of Periacetabular Osteolysis

Stamenkov

Neale

Kane

et al. 2014

The Journal of Arthroplasty

View full text Add to dashboard Cite

“…Femoral component subsidence of between 5 and 14 mm was observed in 8 cases. At 1-year follow-up, Egawa et al (2009) found substantial new mineralization in 10 patients with symptomatic osteolysis who were treated with calcium sulfate bone graft substitute.…”

Section: Discussionmentioning

confidence: 98%

Impaction grafting of the acetabulum with ceramic bone graft substitute

et al. 2013

View full text Add to dashboard Cite

Background and purpose Loss of bone stock remains a challenge in revision hip surgery. Grafting with allograft is well established, but there are problems with availability, cost, infection, antigenicity, reproducibility, and stability of the created construct. BoneSave is a biphasic porous ceramic consisting of sintered 80% tricalcium phosphate and 20% hydroxyapatite. In vitro and in vivo studies, including its use mixed with allograft, have shown good results in impaction grafting. This is the first reported series of its use alone in impaction grafting of the acetabulum.Methods Methods We conducted a retrospective review of a cohort of 43 consecutive patients undergoing impaction grafting of contained acetabular defects by multiple surgeons at a single centre. All patients received uncemented acetabular components. They were followed up radiographically, together with self-reported satisfaction scale (SAPS), Oxford hip score (OHS), and Short-Form 12 (SF12) health survey. Kaplan-Meier survivorship analysis was performed with revision of the acetabular component, revision of any part of the construct, and reoperation as endpoints.Results The fate of all cases was known. Mean follow-up was 4 years. 5 patients died during follow-up, with their constructs in situ. The survivorship of the acetabular component was 98% (95% CI: 85–100) at 7 years. 1 acetabular component was revised for infection and there was 1 radiographic acetabular failure. The median OHS was 36 (6–48), the median SF12 PCS was 36 (14–57), the median SAPS was 75 (0–100), and the median SF12 MCS was 50 (23–64). The graft material had incorporated in all 3 zones of the acetabulum in 33 out of 37 cases with complete radiographic follow-up.Interpretation Medium-term results show that BoneSave alone is a reliable material for impaction grafting of contained defects in the acetabulum at revision surgery.

show abstract

“…Früher ist davon ausgegangen worden, dass ein alleiniger Gleitpaarungswechsel die Osteolysen nicht stoppen kann. Inzwischen liegen Studien vor, die auch ohne Grafting zumindest sistierende oder minimal rückläufige Osteolysen zeigen [40,41,48,53,54], wenn der "Partikelgenerator" eliminiert wurde. Dennoch gilt Impaction Grafting mit allogenem Knochen als Standardvor allem bei stabilitätskritischen Osteolysen.…”

Section: Auffüllung Von Osteolysenunclassified

“…Die Auffüllung von Osteolysen ist nach Kürettage der Pseudomembran über die Schraubenlöcher oder über einen transossären Zugang möglich. Dabei gelingt die Osteolysenauffüllung durchschnittlich zu 43 % [54]. Besitzt die Pfanne keine Schraubenlöcher, kann ein kortikales Fenster am Os ilium ausgemeißelt werden, das allerdings die Stabilität der Pfanne nicht gefährden sollte.…”

Section: Auffüllung Von Osteolysenunclassified

Azetabuläre Osteolysen bei Hüfttotalendoprothese – wann kann die Pfanne belassen werden?

et al. 2016

View full text Add to dashboard Cite

Periacetabular osteolysis is a frequent long-term complication of cementless total hip arthroplasty. The decision whether to retain or to revise a cup in the presence of osteolysis remains a challenge. The options are regular clinical and radiological check-ups, isolated liner exchange with and without bone grafting, and complete cup revision. Thorough preoperative diagnostics, including a medical history, examination and imaging, are mandatory for correct decision making. In most patients, computed tomography is useful to assess periacetabular osteolysis. If the cup is well-fixed and positioned in an asymptomatic patient without progressive osteolysis and no implant defect or higher grade polyethylene wear and no signs of infection, continuous clinical and radiological monitoring is preferred. If imaging reveals cup loosening, malposition, osteolysis localised in a weight-bearing area, imminent or present periprosthetic fractures, rapid progressive osteolysis, implant defects or massive inlay wear, surgical treatment may be preferred. Cup revision is usually performed in such patients. If the cup is well-positioned and well-fixed in the X-ray, the procedure has to be discussed with the patient individually. Apart from patient-specific risk factors, the risk of further progression has to be assessed. Isolated liner exchange can be performed if the patient is asymptomatic and the cup proves to be stable intraoperatively. It is still unclear whether filling osteolyses through screw holes or osseous windows is of long-term benefit.

show abstract

A Three-dimensional Method for Evaluating Changes in Acetabular Osteolytic Lesions in Response to Treatment

Abstract: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Cited by 13 publications

References 31 publications

Cemented Liner Exchange With Bone Grafting Halts the Progression of Periacetabular Osteolysis

Cemented Liner Exchange With Bone Grafting Halts the Progression of Periacetabular Osteolysis

Impaction grafting of the acetabulum with ceramic bone graft substitute

Azetabuläre Osteolysen bei Hüfttotalendoprothese – wann kann die Pfanne belassen werden?

Contact Info

Product

Resources

About