Classification and Reconstruction in Revision Acetabular Arthroplasty With Bone Stock Deficiency

Garbuz, D S; Morsi, Elsayed; Mohamed, Nizar; Gross, Allan E.

doi:10.1097/00003086-199603000-00012

Cited by 114 publications

(56 citation statements)

References 19 publications

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“…The remaining 53 patients (64 hips) had a mean age of 54 years (range, 28-83) at the time of surgery and a mean followup duration of 16 years (range, . Among the 53 patients, five patients died after a mean followup of 12 years (range, 7-15) and 10 were lost to followup after a mean followup of 12 years (range, [5][6][7][8][9][10][11][12][13][14][15][16][17]. There were 36 patients with more than 15 years followup and 16 patients with more than 20 years followup.…”

Section: Methodsmentioning

confidence: 99%

“…A minor column allograft was indicated for a Type III acetabular defect when the defect was less than 50% but more than 30% of the acetabulum. A defect less than 30% did not need grafting and a defect more than 50% needed a major column allograft in conjunction with a protective Burch-Schneider ilioischial cage or a Muller reinforcement roof ring [5].…”

Section: Methodsmentioning

confidence: 99%

“…It should also be sufficiently simple for practical use. We previously classified acetabular bone defects into Type 1, no major bone loss; Type 2, contained bone loss; Type 3, uncontained bone loss with defect size less than 50% of acetabulum; and Type 4, uncontained bone loss with defect size greater than 50% of acetabulum [5,17]. Although this classification has not been formally validated with implant survivorships, it is more reproducible and reliable than others [19] such as the AAOS/D'Antonio classification [2] and the Paprosky classification [16].…”

Section: Introductionmentioning

confidence: 99%

“…The use of high hip center arthroplasty has not been widespread and has been associated with leg shortening, impinging instability, lower functional scores and survivorship. Morag et al [13] reported poorer survivorship (82% versus 94%), mean WOMAC scores (62 versus 70) and mean Harris Hip scores (70 versus 83) in patients with high hip centers ([ 35 mm above radiological teardrop, n = 31) compared to patients without high hip centers (n = 32) after revision at a mean followup of 10 years (range, [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Studies reporting on the use of uncemented oblong cups were few with 90% midterm survivorships, but no long-term results [8,10].…”

Section: Introductionmentioning

confidence: 99%

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Long-term Results for Minor Column Allografts in Revision Hip Arthroplasty

Lee

Raz²,

Safir³

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background While acetabular structural allografts provide an important alternative for reconstructions, concerns remain with long-term graft resorption, collapse, and failure. Midterm studies of minor column (shelf) allograft suggest reasonable survival but long-term survival is unknown. Questions/purposes We therefore assessed long-term graft/cup survivorship, functional scores, radiographic resorption, and complications associated with minor column allograft. Methods We retrospectively reviewed 74 patients (85 hips) with a mean age of 54 years (range, 28-83 years) undergoing acetabular cup revision using a minor column allograft. A minor column allograft was used in uncontained acetabular bone defects sized between 30% and 50% of the acetabulum. Graft failure was considered to occur when the graft required revision with another graft, metal augment, reconstruction cage, or excision arthroplasty. The minimum followup was 5 years (mean, 16 years; range, 5.3-25 years). Results Twenty-three patients (27 hips) had rerevision for all causes at a mean time to rerevision of 6.9 years (range, 0.1-23). Fifteen grafts failed at a mean time-to-rerevision of 6.1 years (range, 0.5-23.2). The 15-and 20-year Kaplan-Meier survivorships were 61% and 55% for cups and 78% for grafts with rerevision for all causes as end point. With rerevision for aseptic loosening as end point, survivorships were 67% and 61% for cups and 81% for grafts. The mean modified Harris hip scores were 41 (range, 20-60) preoperatively, 73 (range, 40-95) at 1 year postoperatively and 73 (range, 26-93) at last followup.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Long-term Results for Minor Column Allografts in Revision Hip Arthroplasty

Lee

Raz²,

Safir³

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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“…Migration of the cup was estimated in relation to the line between the tear drops. 10 Clinical failure was defined as any need for revision of the acetabular component. Radiological failure of the reconstruction was defined as migration of more than 5 mm in any direction, or progressive radiolucent lines in all three zones on conventional radiographs.…”

Section: Methodsmentioning

confidence: 99%

Acetabular revision with impacted morsellised cancellous bone grafting and a cemented cup

Schreurs

Bolder

Gardeniers

et al. 2004

The Journal of Bone and Joint Surgery. British volume

133

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This study presents the clinical and radiological results of 62 consecutive acetabular revisions in 58 patients, at a mean of 16.5 years follow-up (15 to 20). The Kaplan-Meier survivorship for the cup with end-point revisions for any reason, was 79% at 15 years (95% confidence interval (CI); 67 to 91). Excluding two revisions for septic loosening at three and six years, and one revision of a well-fixed cup after 12 years in the course of a femoral revision, the survivorship was 84% at 15 years (95% CI; 73 to 95). At review there were no additional cases of loosening, although seven acetabular reconstructions showed radiolucent lines in one or two zones. Acetabular revision using impacted large morsellised bone chips (0.7 cm to 1.0 cm) and a cemented cup, is a reliable technique of reconstruction, when assessed at more than 15 years.Loss of bone stock compromises the outcome in revision of total hip arthroplasty. The longterm results of most techniques of acetabular revision remain unclear and few reports are available on the outcome beyond ten years. [1][2][3][4] From a biological viewpoint the reconstruction of the bone stock with grafted bone is an attractive option.Following the experience of Hastings and Parker 5 and McCollum, Nunley and Harrelson 6 with protrusio acetabuli, we have used a modified technique of bone grafting for acetabular revisions using tightly impacted morsellised bone chips and cemented cups. In 1998 we described the outcome of this technique in 60 procedures followed for more than ten years. 7 We now report the outcome at 15 to 20 years.

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Cemented versus cementless surgical approach for total hip arthroplasty revision

Meek

Allan

2005

Cochrane Database of Systematic Reviews

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Classification and Reconstruction in Revision Acetabular Arthroplasty With Bone Stock Deficiency

Cited by 114 publications

References 19 publications

Long-term Results for Minor Column Allografts in Revision Hip Arthroplasty

Long-term Results for Minor Column Allografts in Revision Hip Arthroplasty

Acetabular revision with impacted morsellised cancellous bone grafting and a cemented cup

Cemented versus cementless surgical approach for total hip arthroplasty revision

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