Total hip arthroplasty with shelf grafts using uncemented cups

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

doi:10.1016/s0883-5403(96)80164-1

Cited by 68 publications

(22 citation statements)

References 15 publications

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“…Our experiences with acetabular allografting in revision THR confirm the encouraging results of some recently published studies (Zehntner and Ganz 1994, Peters et al 1995, Morsi et al 1996a (Table 6). However, when analyzing our results in detail, we conclude that the answer to the place for allografts in the treatment of severe acetabular deficiencies must be a differentiated one.…”

Section: Discussionsupporting

confidence: 86%

Acetabular revision with allograft bone: 103 revisions with 3 reconstruction alternatives, followed for 0.3–13 years

Böhm

Banzhaf

1999

Acta Orthopaedica Scandinavica

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Section: Discussionsupporting

confidence: 86%

Acetabular revision with allograft bone: 103 revisions with 3 reconstruction alternatives, followed for 0.3–13 years

Böhm

Banzhaf

1999

Acta Orthopaedica Scandinavica

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“…Bulk bone grafting offers advantages: the cup may be placed in an anatomic position rather than a high one, it provides support for the acetabular component, and if incorporated it would provide beneficial bone stock for any future revision surgery. Although the importance of coverage and initial stability of the socket is accepted as a principle, numerous authors have reported high rates of autograft resorption, collapse of the bone graft, and socket loosening [7, 8, 10, 12, 21, 22, 28, 31]. Mulroy and Harris [22] reported failure of 46% of their cemented series by 11.8 years.…”

Section: Introductionmentioning

confidence: 99%

High Long-term Survival of Bulk Femoral Head Autograft for Acetabular Reconstruction in Cementless THA for Developmental Hip Dysplasia

Kim

Kadowaki

2010

Clinical Orthopaedics &Amp; Related Research

110

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BackgroundDeficient acetabula associated with acetabular dysplasia cause difficulty achieving adequate coverage of the acetabular component during THA. Autografting with the removed femoral head has been used for several decades to achieve better coverage, but the long-term benefits of this technique remain controversial, with some series reporting high rates of graft resorption and collapse.Questions/purposesWe evaluated the fate of bulk femoral head autograft for acetabular reconstruction in cementless THA for developmental hip dysplasia.Patients and MethodsWe retrospectively reviewed 70 patients (83 hips) (68 women, two men) with a mean age of 57 years at index surgery. According to the classification of Crowe et al. for hip dysplasia, 10 hips were classified as Type I, 45 as Type II, 19 as Type III, and nine as Type IV. Minimum followup was 9 years (mean, 11 years; range, 9–14 years).ResultsWe observed no collapsed grafts. In all patients we observed disappearance of the host-graft interface and appearance of radiodense bands in the grafts bridging host iliac bone and at the lateral edges of the acetabular sockets; remodeling with definite trabecular reorientation was seen in 90%. The 10-year survival rate without acetabular revision for any reason was 94%. The mean Merle d’Aubigné and Postel hip score improved from a mean of 9.1 preoperatively to 17.2 at last followup.ConclusionsCementless THA combined with autologous femoral bone graft in patients with developmental dysplasia resulted in a high rate of survival. Structural bone grafting achieved a stable construct until osseointegration occurred. We believe the radiodense bands represent a radiographic sign of successful completion of repair of the deficient acetabulum. Congruous and stable contact of the cancellous portion of the graft to the host bed by impaction and use of improved porous cementless sockets may be associated with successful socket survival.Level of Evidence Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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“…However, biologic fixation of a cementless porous-coated component is unlikely when over 50% of the host bone-bed has been lost [17,23,32]; the amount of porous coating in contact with living host-bone then is often limited and bone ingrowth fixation is not obtained [23]. Other surgical techniques include structural allograft with either cementless or cemented cups, implantation of nonhemispheric cementless cups (triflanged, oblong cups), new biomaterials such as tantalum cups and devices, or antiprotrusio cages.…”

Section: Introductionmentioning

confidence: 99%

“…Other surgical techniques include structural allograft with either cementless or cemented cups, implantation of nonhemispheric cementless cups (triflanged, oblong cups), new biomaterials such as tantalum cups and devices, or antiprotrusio cages. Midterm results of these different techniques vary [2,12,16,28,32].…”

Section: Introductionmentioning

confidence: 99%

The Survival and Fate of Acetabular Reconstruction With Impaction Grafting for Large Defects

García-Cimbrelo

Cruz-Pardos

García-Rey

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background Impaction bone grafting has been used for acetabular reconstruction in revision surgery. However, most series do not establish differences in survival in revisions with differing severity of bone loss. Questions/purposes We therefore determined (1) the survival rate for rerevision associated with varying degrees of bone loss; (2) the frequency with which bone graft resorption occurred; and (3) whether the reconstruction restored the anatomic center of rotation of the hip. Methods We retrospectively reviewed 165 patients (181 hips) who underwent rerevision for major bone loss. Using the classification of Paprosky et al. 98 hips had a Grade 3A defect and 83 a Grade 3B. We determined survival rates for revision and graft resorption. Cup position was determined measuring vertical and horizontal positions and the distance from the center of the prosthetic femoral head to the normal center of rotation of the hip in both groups according to Ranawat. The minimum followup until rerevision or the latest evaluation was 0.3 years months (mean, 7.5 years; range, 0.3-17.7 years). Results The survival rate for revision at 8 years was 84% (95% confidence interval: 61-100) for Grade 3A and 82% (95% confidence interval: 68-100) for Grade 3B. Twelve hips were rerevised. Seventeen grafts showed bone resorption. Acetabular cup position was anatomically restored in both Grades 3A and 3B. Conclusions The midterm results for impacted bone allograft and cemented all-polyethylene cups were similar in both Grade 3A and Grade 3B hips. Acetabular reconstruction allows anatomic positioning of the cups and is associated with a low rate of rerevision.

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Total hip arthroplasty with shelf grafts using uncemented cups

Cited by 68 publications

References 15 publications

Acetabular revision with allograft bone: 103 revisions with 3 reconstruction alternatives, followed for 0.3–13 years

Acetabular revision with allograft bone: 103 revisions with 3 reconstruction alternatives, followed for 0.3–13 years

High Long-term Survival of Bulk Femoral Head Autograft for Acetabular Reconstruction in Cementless THA for Developmental Hip Dysplasia

The Survival and Fate of Acetabular Reconstruction With Impaction Grafting for Large Defects

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