Acetabular reconstruction with impaction bone grafting and cemented polyethylene socket in total hip revision arthroplasty

Kostensalo, Inari; Seppänen, Matti; Virolainen, Petri; Mokka, Jari; Koivisto, Mari; Mäkelä, Keijo

doi:10.1177/1457496914568408

Cited by 18 publications

(7 citation statements)

References 31 publications

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“…The graft should be prepared using large rongeurs or a bonemill, although the latter produces a smaller size bone chip. Our experience confirms previously published data 7 11 12) showing that larger bone chip sizes of around 8 mm produce increased stability for acetabular IBG; therefore–despite being time-consuming–we recommend hand-made bone chips using rongeurs ( Fig. 1 , 2 , 3 ).…”

Section: Technical Aspects Of Impaction Bone Graftingsupporting

confidence: 88%

A Review and Description of Acetabular Impaction Bone Grafting: Updating the Traditional Technique

Mirza

Sadiq

2021

Hip & Pelvis

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Restoring acetabular bone loss in revision hip arthroplasty is a major challenge for the orthopaedic surgeon. This paper discusses the traditional cemented technique of impaction bone grafting as applied to the acetabulum, as well as the evolution of the technique to employ uncemented implants. Some of the recent published literature regarding these techniques is reviewed and the personal experiences of the senior author with these techniques are also reported.

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Section: Technical Aspects Of Impaction Bone Graftingsupporting

confidence: 88%

A Review and Description of Acetabular Impaction Bone Grafting: Updating the Traditional Technique

Mirza

Sadiq

2021

Hip & Pelvis

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“…1,2 Over the previous decades, the incidence of revision and re-revision has risen because of an ageing population as well as an increasing occurrence of THA in young patients. 3 Periprosthetic hip fractures are increasingly frequent; their incidence is reported to be between 1% to 2.3% of primary implant and up to 7.8% in revision hip implants. 4 Periprosthetic fractures are complex injuries and most commonly affect an elderly cohort of patients with multiple co-morbidities.…”

Section: Introductionmentioning

confidence: 99%

“…1,2 Over the previous decades, the incidence of revision and re-revision has risen because of an ageing population as well as an increasing occurrence of THA in young patients. 3…”

Section: Introductionmentioning

confidence: 99%

Femoral revision in periprosthetic fractures using a titanium modular fluted tapered stem: mortality and clinical and radiological outcomes

et al. 2020

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Introduction: The aim of the study was to evaluate the mortality and the outcomes of femoral revision in periprosthetic femoral fractures (PFF) using a titanium modular fluted tapered stem. Methods: We retrospectively reviewed femoral revisions performed for PFF with a titanium modular fluted tapered stem in 25 patients. The average age was 74.32 years. In 21 patients the type of fracture was Vancouver B2 and type B3 in 4 cases. The mean follow-up was 29.16 (0.83–104.1) months SD ± 29.49. Results: The 30-day and 1-year mortality were 8% and 12% respectively. The mean value of the Charlson Comorbidity Index was 4.8 and the mean value of ASA score was 2.4. The average time to surgery from admittance was 5.45 days with 20% of patients operated on within 48 hours. A significant correlation was found between ASA score and mortality. The mean HHS was 76 points; good-excellent results were recorded in 56% of patients. 72% had no pain and 28% had slight pain (VAS 1–3). 52% of patients were able to walk without pain, limp or aids. The mean implant subsidence was 1.57 mm and superior to 5 mm in 2 cases. As complications we recorded 4 implant dislocations (16%) and 2 infections. Reoperation rate was 12%. Conclusions: Femoral revision with a modular fluted tapered stem in patients with periprosthetic fractures results in good clinical and radiological outcomes. However, mortality remains high and, despite the modularity design, dislocation is the most frequent complication.

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“…However, other authors reported inferior results, both in major bone loss and without correlation with the type of defect. 27,28 The surgeon’s experience makes the difference in this demanding technique. Iwase reported favourable results only in cases of moderate bone loss with a maximum depth of 20 mm and without multiple segmental defects.…”

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 reconstruction with impaction bone grafting and cemented polyethylene socket in total hip revision arthroplasty

Abstract: Our results were inferior compared to some previous studies. Impaction bone grafting of acetabular defects in revision total hip arthroplasty may not always provide a reliable bone stock in long-term.

Cited by 18 publications

References 31 publications

A Review and Description of Acetabular Impaction Bone Grafting: Updating the Traditional Technique

A Review and Description of Acetabular Impaction Bone Grafting: Updating the Traditional Technique

Femoral revision in periprosthetic fractures using a titanium modular fluted tapered stem: mortality and clinical and radiological outcomes

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

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