Modified exeter technique for the reconstruction of femoral bone loss in revision total hip arthroplasty. Does prosthesis stability affect remodeling of the graft?

Thomasson, E. de; Guingand, O.; Mazel, C.

doi:10.1007/bf02803171

Cited by 3 publications

(1 citation statement)

References 11 publications

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“…Methods of allograft fixation include cementation into the distal femur [11], the use of long prosthesis with or without distal locking or step-cut technique combined with pins or plates fixation [9] [13]. Biomechanical studies conducted on cadavers demonstrate a good stability of distal cementation systems [32]- [34]. There is, however, a high risk of non-union.…”

Section: Discussionmentioning

confidence: 99%

Proximal Femoral Allograft in Two-Stage Revision for Failed Septic Hip Arthroplasty

Traoré¹,

Tribak²,

Be³

et al. 2015

OJO

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Infection after hip prostheses is a potentially devastating complication, and a serious medical and surgical challenge, especially when associated with Paprosky type III femoral bone loosening. Treatment is difficult and options are limited. We report on a 2-stage revision of 15 patients undergoing femur reconstruction with massive allografts. Materials and methods: This was a prospective study which included 15 patients (10 men and 5 women) with infected hip prosthesis, associated with Paprosky type III femoral proximal massive bone loss. The median age of patients was 64 years with a preoperative functional status score of 6. The average number of procedures to the same hip after the first arthroplasty was 6. All patients benefited from a 2-step surgery with massive allografts and locking prosthesis. The average follow-up time was 36 months. Results: Infection was monomicrobial in 14 cases; and was polymicrobial in 4 cases. Methicillin-resistant Staphylococcus epidermidis was the main bacteria (n = 10). The average C-reactive protein level before the second procedure was 2.3 ± 3.4. It was normalized in 8 cases. We recorded 13 cases of primary consolidation without another surgery, 3 cases of relapse, 2 traumatic dislocations and 2 fractures of the allograft. Conclusion: Hip prosthesis infection is a potentially catastrophic complication with significant negative ramifications for both the patient and the healthcare system. Massive allografts use in Paprosky III femoral defect remains very attractive for bone stock restoration and hip function improvement.

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