Post-operative hip centre restoration and migration after impaction bone grafting in revision and complex primary hip arthroplasty

Abdelnasser, Mohammad Kamal; Khalifa, Ahmed A.; Mahran, Mohammad A; Mosa, Mohamed; Bakr, Hatem; Khalifa, Yaser E.; Abdelaal, Ahmed M.

doi:10.1007/s00590-019-02458-8

Cited by 2 publications

(4 citation statements)

References 29 publications

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“…Research by Abdelnasser et al . concluded that a better anatomical center of rotation of the acetabulum could be obtained with the IBG technique and that there was less cement cup migration after reconstruction of AAOS type I and II bone defects than type III, and suggested that other options could be considered in acetabular reconstruction of these large acetabular bone defects 40 . Consequently, biological techniques should be used to reconstruct skeletal defects in cases with substantial bone defects to restore sufficient bone stock and normal anatomical center of rotation and obtain excellent clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Research by Abdelnasser et al concluded that a better anatomical center of rotation of the acetabulum could be obtained with the IBG technique and that there was less cement cup migration after reconstruction of AAOS type I and II bone defects than type III, and suggested that other options could be considered in acetabular reconstruction of these large acetabular bone defects. 40 Consequently, biological techniques should be used to reconstruct skeletal defects in cases with substantial bone defects to restore sufficient bone stock and normal anatomical center of rotation and obtain excellent clinical outcomes. Although a titanium mesh was used in all primary THA cases and some revision cases in the present study, there were significant differences in the types of bone defects and whether titanium mesh was used included in each of the groups; therefore, it was not possible to evaluate whether there were significant differences in osseointegration after impaction grafting between subgroups with different bone defect sources of grafted bone and whether titanium mesh was used.…”

Section: Effect Of Bone Grafts In Restoring Bone Stockmentioning

confidence: 99%

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Impaction Bone Grafting with Low Dose Irradiated Freeze‐Dried Allograft Bone for Acetabular Reconstruction

Tan

et al. 2022

Orthopaedic Surgery

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Objective: Reconstruction of acetabular defects has been extremely challenging in both primary and revision total hip arthroplasty (THA). Impaction bone grafting (IBG) can restore the acetabulum bone mass and anatomically reconstruct the acetabulum. Our study aimed to report the short and medium-term clinical and radiographic outcomes of IBG for acetabular reconstruction in the cemented THA in the Chinese population.Methods: This was a single-center retrospective review enrolling 57 patients between May 2013 and July 2019. The patients with acetabular defects were treated with IBG, using low dose irradiated freeze-dried allograft bone with or without autograft bone, in the cemented THA performed by one senior surgeon. Harris hip score (HHS), standard pelvis anterior-posterior radiograph and lateral hip radiograph were obtained before operation and at 1 week, 3 months, 12 months, and yearly. Graft osteointegration was evaluated by Oswestry's criteria, and complication was documented at the last follow-up. Independent sample ANOVA test and Pearson chi-square tests are used for statistical analysis.Results: There were 61 hips in 57 patients. The average follow-up time was 35.59 months (5-77 months). According to AAOS classification, a total of 18 hips were identified as segmental bone deficiency (type I), with 21 and 22 hips for cavitary bone deficiency (type II) and the combined bone deficiency (type III), respectively. The average HHS was improved from 44.49 (range: 32-58) preoperatively to 86.98 (range: 78-93) postoperatively. Graft osteointegration was satisfactory (Oswestry score ≥2) in all patients. No dislocation occurred in the 57 patients (61 hips) during followup. Although one cup migrated, no revision, re-revision, radiographic loosening, graft bone lysis, or postoperative complications were detected at the final follow-up.Conclusions: IBG with low-dose irradiated freeze-dried allograft bone in acetabular bone defect reconstruction is a reliable technique for restoring acetabular bone defects in THA.

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Section: Discussionmentioning

confidence: 99%

Section: Effect Of Bone Grafts In Restoring Bone Stockmentioning

confidence: 99%

Impaction Bone Grafting with Low Dose Irradiated Freeze‐Dried Allograft Bone for Acetabular Reconstruction

Tan

et al. 2022

Orthopaedic Surgery

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“…Primary and secondary defects of the acetabulum can lead to a non-anatomical positioning of the cup with a potential higher rate of failure, while an anatomical biomechanical position of the cup increases longevity and decreases stress 4,5 . Slooff et al described in the 1980s a technique of impaction bone grafting (IBG) for restoring the anatomical COR with bone grafts for a biological reconstruction with good short-and long-term survival [6][7][8] .While using a biological graft for restoring the COR and establishing a new bony bed for the cup is advantageous, resorption, cup migration and a lesser primary stability in some cases are serious limitations of this technique. So metallic support like the Trabecular-Metal-Technology (Fa.…”

mentioning

confidence: 99%

mentioning

confidence: 99%

Mid-term results in revision hip arthroplasty with impaction bone grafted cup reconstruction for acetabular defects

Rohe

Dörr

Böhle

et al. 2022

Sci Rep

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Acetabular defects are a challenging condition for surgeons in revision THA. A crucial aim is an anatomical restoration of the centre of rotation (COR) through grafts. The aim of this study was to determine the cup survival after biological restoration of acetabular defects in THA and the effect of Paprosky classification, age, BMI, and number of previous operations on cup survival. Retrospectively patients with a cup exchange and an impaction of cortico-cancellous or bulk grafts between 2009 and 2012 were included with a follow up with a minimum of 5 year. Implant failure was defined as radiographic loosening or explantation of the cup. The acetabular defect situation was classified to Paprosky. 82 patients (58 female 70.7%) were included. 26 patients were not available to contact. 56 patients (40 female 71.4%) remained for survival analysis with mean age of 75.6 ± 8 years. Survival of the cup after 5 years was 90% and after 7.8 years 88%. There was no difference in survival concerning defect classification, type of implant or graft, age, BMI, and number of previous operations. Patients on the follow up reached an HHS of 67.4 ± 19, a WOMAC Score of 33.4 ± 25.4 points and an unsatisfactory result in the SF-36. Impaction bone grafting of acetabular defects is a good option with satisfactory biomechanical results and survival for small defects. Predictive factors for cup survival could not be clarified in our study. So, the correct indication, knowing the limits of the methods and the correct choice of implant allow a defect-oriented approach and are decisive for the success of the operation.

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Post-operative hip centre restoration and migration after impaction bone grafting in revision and complex primary hip arthroplasty

Cited by 2 publications

References 29 publications

Impaction Bone Grafting with Low Dose Irradiated Freeze‐Dried Allograft Bone for Acetabular Reconstruction

Impaction Bone Grafting with Low Dose Irradiated Freeze‐Dried Allograft Bone for Acetabular Reconstruction

Mid-term results in revision hip arthroplasty with impaction bone grafted cup reconstruction for acetabular defects

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