Periprosthetic fractures with extensive bone loss treated with onlay strut allografts

Barden, B.; Knoch, Marius von; Fitzek, J.; Löer, F.

doi:10.1007/s00264-002-0423-8

Cited by 21 publications

(9 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The average Harris score for patients at 3 months and 12 months was 48.8 ± 6.9 and 74.4 ± 9.7, respectively. This result is similar to the previous result [32][33][34] .…”

Section: Discussionsupporting

confidence: 93%

Efficacy of two bone grafting methods for Vancouver B3 type PFFs in uncemented stems: a retrospective study of functional and radiological outcomes from 2000 to 2017

Sun

Chen

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Peripheral femoral fractures (PFFs) are a devastating complication after total hip arthroplasty (THA). The accepted treatment for the Vancouver B3 fracture is revision surgery. However, there is still no consensus on which bone grafting technique to treat the bone defect around the femoral prosthesis in revision surgery. Therefore, we designed a retrospective study to evaluate the efficacy of ICA (impacted cancellous allograft) and ICA+CSA (cortical strut allograft) in B3-type PFFs revision surgery using uncemented stems. Methods We retrospectively assessed 47 Vancouver-type B3 PFFs in 47patients who have been treated between 2000 and 2017. All patients underwent intraoperative bone grafting.18 patients treated with ICA and 29 patients treated with ICA+CSA. Functional outcomes were assessed using Harris hip score, SF-36 scores and complications. Radiological findings were classified using Engh standard. Kaplan–Meier survival curve was used to assess patient and implant survival. Results There were 18 males and 29 females with an average age of 62.5 ± 9.9 years. The average follow-up time was 63.5 months. 90.7% of patients achieved fracture healing and 17.0% received secondary revision surgery. The overall 5-year Kaplan–Meier survival rate for the patients was 64.7% (95% CI, 50.6-78.8), and the 10-year rate was 47.4% (95% CI, 30.4–64.5). The last evaluated mean SF-36 was 46.1; Harris hip scores were 44.6 (3 months), 61.7 (12 months); respectively. Conclusions The use of ICA and ICA+CSA to reconstruct bone stock can provide stable prosthesis support and satisfactory fracture healing rate.

show abstract

“…The average Harris score for patients at 3 months and 12 months was 48.8 ± 6.9 and 74.4 ± 9.7, respectively. This result is similar to the previous result [32][33][34] .…”

Section: Discussionsupporting

confidence: 93%

Efficacy of two bone grafting methods for Vancouver B3 type PFFs in uncemented stems: a retrospective study of functional and radiological outcomes from 2000 to 2017

Sun

Chen

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…In their cohort, the mean Harris Hip and WOMAC scores were similar to our results. In the literature, after such revisions, the time for full weight-bearing mobilization of patients has been shown between three and seven months [23,36]. We allowed full weight-bearing mobilization in the second month without waiting for a complete union.…”

Section: Discussionmentioning

confidence: 99%

Onlay fibula autografting technique and its comparison with cortical allograft for the reconstruction of periprosthetic bone defects around the femur

Tuncay

Tozun

Aliyev

et al. 2020

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

Background Bone defect around the femur related to revisions or periprosthetic fractures (PFF) is an issue. We present a bone defect reconstruction technique in femoral revisions and/or PFF using fibula autograft and compared our radiological and clinical results to that of allograft. Methods A total of 53 patients who underwent revision hip arthroplasty and/or PFF fixation with the use of cortical fibula autograft (FG group) or cortical allograft (CG group) were evaluated. After exclusions, 20 patients who had minimum two years of follow-up were investigated for each group, for their radiological and clinical outcomes. Results In FG and CG groups, the median ages were 69.5(44-90) and 62(38-88) years, follow-ups were 59(28-72) and 120(48-216) months, defect lengths were seven (1-10) and ten (1-17) cm, and grafts lengths were 16.5(10-30) and 20(12-37) cm, respectively. The rate of graft incorporation was 90% in each group and median time to incorporations were seven (4-12) and 12(6-24) months (p < 0.001), and graft resorption (moderate and severe) rates were 10% and 25% (p = 0.41), respectively. Median Harris Hip (77.6 vs 78.0), WOMAC (23.2 vs 22), SF-12 physical (50.0 vs 46.1), and SF-12 mental (53.8 vs 52.5) scores were similar between the groups, respectively. Kaplan-Meier survivorship analyses revealed an estimated mean survival of 100% at six years in FG group and 90% at 14 years in CG group. Conclusion In the reconstruction of periprosthetic bone defects after femoral revision or PPF, onlay cortical fibula autografts provide comparable clinical and radiological outcomes to allografts. Its incorporation is faster, it is cost-effective and easy to obtain without apparent morbidity.

show abstract

“…Cases of failure of hip arthroplasty and periprosthetic fractures frequently evolve with diminution of the femoral bone stock, thus making their treatment a challenge for hip surgeons 1 , 2 . A variety of treatment options have been reported in the literature, and among these is the use of cortical structural homologous bone grafts, which has become an attractive method in selected cases 3 , 13 , 16 .…”

Section: Discussionmentioning

confidence: 99%

“…Barden et al (16) evaluated 19 patients with periprosthetic factures and significant bone loss that were treated with structural homologous bone grafts, with a mean follow-up of 3.7 years. Consolidation occurred in all the cases, with an increase in the femoral bone stock.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Use of Cortical Structural Homologous Bone Graft in Femoral Reconstructive Surgery

Roos

Giora

et al. 2010

Revista Brasileira de Ortopedia (English Edition)

View full text Add to dashboard Cite

To perform a clinical and radiographic assessment of patients undergoing surgical treatment using a cortical structural homologous bone graft for femoral reconstruction following mechanical failure of total hip arthroplasty and periprosthetic fractures. Methods: A retrospective study was conducted on 27 patients who underwent surgical treatment for femoral reconstruction following mechanical failure of total hip arthroplasty (12 cases) and periprosthetic fractures (15 cases), using a cortical structural homologous bone graft and cemented implants, between June 1999 and February 2008. Of these, 21 fulfilled all the criteria required for this study. The patients underwent pre and postoperative clinical assessments using the Harris Hip Score. Preoperative, immediate postoperative and late postoperative radiographs were also evaluated, with comparisons of fracture consolidation, radiographic signs of graft consolidation, changes to the bone stock and femoral bone quality, and femoral alignment. Results: Nine patients (42.9%) underwent femoral reconstruction following mechanical failure of total hip arthroplasty and 12 cases (57.1%) underwent femoral reconstruction following periprosthetic fracture. Regarding the postoperative clinical classification, the results were considered satisfactory in 85.7% of the cases and unsatisfactory in 14.3%. Radiographic signs of graft consolidation were seen in all cases. There was an increase in bone stock in 90.5% of the hip reconstructions, as measured by the cortical index. Furthermore, the changes to femoral bone quality were considered good in 66.7% of the cases. Conclusion: The use of cortical structural homologous bone grafts for both femoral reconstructive surgery on total hip arthroplasty and periprosthetic fractures is a good treatment option for selected cases, enabling satisfactory clinical and radiographic results.

show abstract

Periprosthetic fractures with extensive bone loss treated with onlay strut allografts

Cited by 21 publications

References 18 publications

Efficacy of two bone grafting methods for Vancouver B3 type PFFs in uncemented stems: a retrospective study of functional and radiological outcomes from 2000 to 2017

Efficacy of two bone grafting methods for Vancouver B3 type PFFs in uncemented stems: a retrospective study of functional and radiological outcomes from 2000 to 2017

Onlay fibula autografting technique and its comparison with cortical allograft for the reconstruction of periprosthetic bone defects around the femur

Use of Cortical Structural Homologous Bone Graft in Femoral Reconstructive Surgery

Contact Info

Product

Resources

About