Acetabular impaction bone grafting in total hip replacement

Ibrahim, Mazin; Raja, Shreya; Haddad, Fares S.

doi:10.1302/0301-620x.95b11.32834

Cited by 40 publications

(21 citation statements)

References 47 publications

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“…Later, the Exeter and Nijmegen groups reported improved outcome with IBG and the usage of cemented cups [ 7 , 8 ]. The results also improved thanks to the use of cementless, porous-coated cups, which lead to improve bone integration [ 9 , 10 ]. However, this technique is limited by the severity of the defect, and the outcome is linked to the Paprosky type of defect [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Functional and radiological outcomes after treatment with custom-made acetabular components in patients with Paprosky type 3 acetabular defects: short-term results

Gruber¹,

Jesenko

Burghuber³

et al. 2020

BMC Musculoskelet Disord

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Background Severe acetabular defects require special treatment with either impaction bone grafting, metal augmented cups or cup-cage constructs. Even these options are often not adequate, especially in hips with Paprosky type 3 defects with loss of anterior and posterior columns. This study investigates the clinical and radiological outcomes of custom-made acetabular components (© Materialise NV, Leuven, Belgium) for Paprosky type 3 defects. Methods Sixteen patients were eligible for this trial, nine of whom agreed to be included. All of them completed one year of follow-up. The Harris hip score and the Oxford hip score were used to compare pre- and postoperative functional outcomes. Radiological follow-up comprised anteversion and inclination of the implanted cup and offset measurements in both hips (femoral, medial, ischial offset and center of rotation). Statistical analyses were performed with IBM SPSS Statistics. Results The mean follow-up time of the nine patients was 12.2 months (range: 10–18). The Oxford hip score and Harris hip score improved from 19.8 and 50.1 to 29.4 and 68.8, respectively (p = 0.009 and 0.01). There were complications in three cases (33.3%), which led to one re-revision (11.1%). Radiologic follow-up showed restoration of the height of the center of rotation and of the global offset. Significant difference was detected in the femoral offset. Conclusions The functional and radiological outcomes are promising. However, long-term outcomes still need to be examined. Level of evidence Therapeutic Level IV.

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Section: Introductionmentioning

confidence: 99%

Functional and radiological outcomes after treatment with custom-made acetabular components in patients with Paprosky type 3 acetabular defects: short-term results

Gruber¹,

Jesenko

Burghuber³

et al. 2020

BMC Musculoskelet Disord

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“…Our case series, even if small, has an asset of being a homogeneous court of patients characterized by an isolated acetabular contained defect treated with hydroxyapatite (mixed with autologous bone and blood obtained from reaming when available) and with cementless implants. IBG is recognized as an efficient method to treat contained acetabular defects [16,23], even if the procedure is described as successful for selected cases of the Paprosky 3 type [24]. A porous, cementless coated socket would lead to bony ingrowth and osteointegration, providing a stable and solid fixation [7].…”

Section: Discussionmentioning

confidence: 99%

Synthetic Bone Grafting in Aseptic Loosening of Acetabular Cup: Good Clinical and Radiological Outcomes in Contained Bone Defects at Medium-Term Follow Up

Parchi

Simonetti

Bonicoli

et al. 2020

IJERPH

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Restoring bone loss is one of the major challenges when facing hip revision surgery. To eliminate the risk of disease transmission and antigenicity of allografts and donor-morbidity of autografts, the use of synthetic bioceramics has become popular in the last decade. Our study investigated the effectiveness of impaction bone grafting (IBG) of contained acetabular defects (Paprosky 2 and 3a) using a porous ceramic-based hydroxyapatite bone substitute (Engipore, provided by Finceramica Faenza S.p.A., Faenza, Italy) mixed with a low percentage of autologous bone (obtained from reaming when available). We retrospectively assessed 36 patients who underwent acetabular revision using IBG using a porous ceramic-based hydroxyapatite bone substitute with cementless implants with a mean follow-up of 4.4 years. We evaluated, at regular intervals, patients clinically (using the Hip Harris Score and Oxford Score) and radiologically to evaluate the rate of incorporation of the graft, the presence of radiolucent lines or migrations of the cup. Clinical scores significantly improved (WOMAC improved from 49.7–67.30, and the HSS from 56–89). The rate of implants’ survival was 100% at our medium follow-up (4.4 years). We reported five cases of minor migration of the cup, and radiolucent lines were visible in seven patients at the last-follow up. The graft was well-incorporated in all patients. The results presented in this study suggest the HA bone substitute is an effective and safe bone graft when facing hip revision surgery; thus, longer follow-up studies are required.

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“…21,22 More recently, uncemented IBG has gained popularity (Fig.1). 23 An appropriate compaction force is necessary also in the case of cementless cups. The high surface-to-volume ratio enhances the creeping substitution, obtaining wider incorporation and reduced risk of delayed collapse when compared with bulky allografts, although the retention of nonunited bone chips surrounded by fibrous tissue is documented.…”

Section: Allograftsmentioning

confidence: 99%

Bone grafts, bone graft extenders, substitutes and enhancers for acetabular reconstruction in revision total hip arthroplasty

Pierannunzii

Zagra

2016

EFORT Open Reviews

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Acetabular bone loss is a relevant concern for surgeons dealing with a failed total hip arthroplasty.Since the femoral head is no longer available, allografts represent the first choice for most reconstructive solutions, either as a structural buttress or impacted bone chips.Even though fresh-frozen bone is firmly recommended for structural grafts, freeze-dried and/or irradiated bone may be used alternatively for impaction grafting. Indeed, there are some papers on freeze-dried or irradiated bone impaction grafting, but their number is limited, as is the number of cases.Xenografts do not represent a viable option based on the poor available evidence but bioactive bioceramics such as hydroxyapatite and biphasic calcium phosphates are suitable bone graft extenders or even substitutes for acetabular impaction grafting.Bone-marrow-derived mesenchymal stem cells and demineralised bone matrix seem to act as reliable bone graft enhancers, i.e. adjuvant therapies able to improve the biological performance of standard bone grafts or substitutes. Among these therapies, platelet-rich plasma and bone morphogenetic proteins need to be investigated further before any recommendations can be made.Cite this article: EFORT Open Rev 2016;1:431-439. DOI:10.1302/2058-5241.160025

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Acetabular impaction bone grafting in total hip replacement

Cited by 40 publications

References 47 publications

Functional and radiological outcomes after treatment with custom-made acetabular components in patients with Paprosky type 3 acetabular defects: short-term results

Functional and radiological outcomes after treatment with custom-made acetabular components in patients with Paprosky type 3 acetabular defects: short-term results

Synthetic Bone Grafting in Aseptic Loosening of Acetabular Cup: Good Clinical and Radiological Outcomes in Contained Bone Defects at Medium-Term Follow Up

Bone grafts, bone graft extenders, substitutes and enhancers for acetabular reconstruction in revision total hip arthroplasty

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