Reinforcement of deficient femur with inlay strut grafts in revision hip arthroplasty: a small series

Otte, Sebastian; Fitzek, J.; Wedemeyer, Christian; Löer, F.; Knoch, Marius von; Saxler, Guido

doi:10.1007/s00402-006-0213-7

Cited by 8 publications

(6 citation statements)

References 18 publications

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“…The radiographic union rate of the strut allograft varies reportedly from 92% to 100% (4, 9, 11). The grafts go through the phases of union, revascularization, remodeling, and maturation.…”

Section: Discussionmentioning

confidence: 99%

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Experience of structural onlay allografts for the treatment of bone deficiency in revision total hip arthroplasty

et al. 2013

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“…The radiographic union rate of the strut allograft varies reportedly from 92% to 100% (4, 9, 11). The grafts go through the phases of union, revascularization, remodeling, and maturation.…”

Section: Discussionmentioning

confidence: 99%

“…Femoral bone deficiency may be reconstructed in connection with revision THAs with the use of cortical onlay strut allografts, and the results have been satisfactory (8–11). Strut grafts become revascularized and incorporated into the surrounding bone tissue if the fit is stable (12).…”

Section: Introductionmentioning

confidence: 99%

Experience of structural onlay allografts for the treatment of bone deficiency in revision total hip arthroplasty

et al. 2013

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“…Ultimately a stable internal fixation with a reduced damage to soft tissues allows an early functional recovery [27]. The use of the plate and the graft of allogenic femoral cortical splint in the treatment of periprosthetic femoral fractures is not a new technique and it has been extensively described by many authors [28]. J.-W. Wang and C.-J.…”

Section: Discussionmentioning

confidence: 99%

The Biological Metallic versus Metallic Solution in Treating Periprosthetic Femoral Fractures: Outcome Assessment

Carta

Fortina

Riva

et al. 2016

Advances in Medicine

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Introduction. The periprosthetic fracture of the femur is, in order of frequency, the fourth leading cause (5.9%) of surgical revision. Our study aims to demonstrate how the grafting of bone splint betters the outcomes. Materials. We treated 15 periprosthetic femoral fractures divided into two groups: PS composed of 8 patients treated with plates and splints and PSS involving 7 patients treated only with plates. The evaluation criteria for the two groups during the clinical and radiological follow-up were the quality of life measured by the Short Form (36) Health Survey (SF-36), Harris Hip Score (HHS), Modified Cincinnati Rating System Questionnaire (MCRSQ), bone healing measured by the Radiographic Union Score (RUS), postoperative complications, and mortality. The evaluation endpoint was set at 24 months for both groups (p < 0.05). Results. The surgery lasted an average of 124.5 minutes for the PS group and 112.6 minutes for the PSS. At 24 months all clinical and radiographic scores were p < 0.05 for the PS group. During follow-up 4 patients (2 in each group) died of causes not related to surgery. Conclusions. The use of the metal plate as opposed to cortical allogenic splint should be taken into consideration as a noteworthy point for periprosthetic femoral fractures.

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“…Whenever it is possible, circumferential press-fit should be applied caudal to the defect situation [ 4 ]. Cancellous, as well as cortical defects should be subjected to augmentation to promote biological downsizing and improve the outcome in following revision procedures [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Femoral defects in revision hip arthroplasty: a therapy-oriented classification

Jaenisch

Kohlhof

Kasapovic

et al. 2021

Arch Orthop Trauma Surg

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Introduction The complex field of femoral defects in revision hip arthroplasty displays a lack of standardized, intuitive pre- and intraoperative assessment. To address this issue, the femoral defect classification (FDC) is introduced to offer a reliable, reproducible and an intuitive classification system with a clear therapeutic guideline. Materials and methods The FDC is based on the integrity of the main femoral segments which determine function and structural support. It focuses on the femoral neck, the metaphysis consisting of the greater and lesser trochanter, and the femoral diaphysis. The four main categories determine the location of the defect while subcategories a, b and c are being used to classify the extent of damage in each location. In total, 218 preoperative radiographs were retrospectively graded according to FDC and compared to intraoperatively encountered bone defects. To account for inter-rater and intra-rater agreement, 5 different observers evaluated 80 randomized cases at different points in time. Results A Cohens kappa of 0.832 ± 0.028 could be evaluated, accounting for excellent agreement between preoperative radiographs and intraoperative findings. To account for inter-rater reliability, 80 patients have been evaluated by 5 different observers. Testing for inter-rater reliability, a Fleiss Kappa of 0.688 could be evaluated falling into the good agreement range. When testing for intra-rater reliability, Cohens Kappa of each of the 5 raters has been analyzed and the mean was evaluated at 0.856 accounting for excellent agreement. Conclusion The FDC is a reliable and reproducible classification system. It combines intuitive use and structured design and allows for consistent preoperative planning and intraoperative guidance. A therapeutic algorithm has been created according to current literature and expert opinion. Due to the combination of the FDC with the recently introduced Acetabular Defect Classification (ADC) a structured approach to the entire field of hip revision arthroplasty is now available.

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Reinforcement of deficient femur with inlay strut grafts in revision hip arthroplasty: a small series

Cited by 8 publications

References 18 publications

Experience of structural onlay allografts for the treatment of bone deficiency in revision total hip arthroplasty

Experience of structural onlay allografts for the treatment of bone deficiency in revision total hip arthroplasty

The Biological Metallic versus Metallic Solution in Treating Periprosthetic Femoral Fractures: Outcome Assessment

Femoral defects in revision hip arthroplasty: a therapy-oriented classification

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