Zementierte versus unzementierte Revisions-Hüftarthroplastik mit verdichtetem Knochenallograft - Prospektiv randomisierte Vergleichsstudie mit Jahres-Follow-up

Nesse, E; Daniel, Bastian

doi:10.1055/s-2003-812405

Cited by 7 publications

(4 citation statements)

References 15 publications

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“…(b) CT at 5 years and 6 months proves rigid fixation in all Gruen zones except in zone 1. randomizing Paprosky grade II patients into two groups intraoperatively, and comparing cementless impaction grafting using Corail stems with cemented impaction bone grafting using polished femoral stems. [4]. They concluded that functional scores and bone density around the femoral stem at up to five years were similar.…”

Section: Discussionmentioning

confidence: 97%

“…In a search of English literature, cementless impaction bone graft in revision THA is scarce [4,12], and there is only one English abstract described by German authors, (Figure 4) showed that the calcar allograft united to the host bone with partial absorption and it showed no further subsidence compared to 1-year X-ray. (b) CT at 5 years and 6 months proves rigid fixation in all Gruen zones except in zone 1. randomizing Paprosky grade II patients into two groups intraoperatively, and comparing cementless impaction grafting using Corail stems with cemented impaction bone grafting using polished femoral stems.…”

Section: Discussionmentioning

confidence: 99%

“…Some clinicians hold the view that conventional cemented impaction bone graft is not ideal for the preservation of bone stock [2], and after 2000, some authors began to report the use of cementless impaction bone grafting using a long stem, with the aim of preserving bone stock [3]. Several authors compared conventional cemented impaction bone grafting using polished Landos Fjord-CrCo stems, and cementless impaction bone grafting using Corail® (DePuy Synthes) stems, and reported that the functional scores were similar [4].…”

Section: Introductionmentioning

confidence: 99%

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A Case of Cementless Impaction Bone Graft in a Revision Total Hip Arthroplasty Requiring Calcar Reconstruction

Ishiguro¹,

Asanuma

Tamaki

et al. 2021

Case Reports in Orthopedics

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Introduction. In cases of bone deficiency or osteoporosis, and especially in revision cases, there were only two options for treatment until the impaction bone graft procedure was proposed. These were cemented or cementless femoral prosthesis. In the early 1990s, the use of impaction bone graft with a cemented mantle had gained popularity and had proven to be clinically effective. In Germany, a cementless impaction bone graft procedure using Corail® (DePuy Synthes) stems was devised, and functional scores were similar to conventional cemented Impaction bone grafts. Case presentation. A 48-year-old man presented with femur loosening of a reamed bipolar arthroplasty performed in 1990. The patient was treated with a cementless impaction bone graft using a Corail® (DePuy Synthes) stem in the femur in revision THA surgery, and the calcar was reconstructed by allograft. Results. At five years, the calcar allograft united with the host bone, and the femoral component showed no subsidence. Conclusion. Calcar reconstruction with a strut allograft, aimed at preventing sinking of the stem was key in this operation. Surgical indication for femoral cementless impaction bone graft should be for loosened femoral prosthesis in a type II Paprosky classification, where only the cortical bone of the isthmus is partially affected, cortical thinning does not exist, and it is mechanically strong enough for the allograft tip impaction. The procedure was safely feasible through the direct anterior approach.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Case of Cementless Impaction Bone Graft in a Revision Total Hip Arthroplasty Requiring Calcar Reconstruction

Ishiguro¹,

Asanuma

Tamaki

et al. 2021

Case Reports in Orthopedics

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“…In another study of BMD changes after uncemented rearthroplasty, Nesse et al (2003) presented a material where all patients received impacted bone allograft. They noted less proximal bone loss than we did, which may be due to the fact that we grafted only half of the patients.…”

Section: Discussionmentioning

confidence: 99%

Large femoral bone loss after hip revision using the uncemented proximally porous-coated Bi-Metric prosthesis

et al. 2009

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Background and purpose Periprosthetic bone loss after uncemented femoral hip revision is a matter of concern. We have used a proximally porous- and hydroxyapatite-coated prosthesis (Bi-Metric) in revision since 1989 and now we report the bone changes. This prosthesis is intended to distribute the forces more evenly and to avoid proximal femoral unloading.Methods 22 patients were unilaterally reoperated because of aseptic loosening. Only patients with a healthy contralateral hip were included. Mean age at revision was 69 (55–80) years. Bone defects were graded by Gustilo-Pasternak and Endo-Klinik classifications. Clinical assessment was performed with Harris hip score. We used radiographs and dual-energy X-ray absorptiometry to evaluate migration, femoral remodeling, and bone mineral density after 72 (30–158) months.Results The mean Harris hip score was 74 (30–100) points at follow-up. Mild thigh discomfort was present in 1 patient and moderate thigh pain in 3 patients. There was no loosening or subsidence. Osteolysis seen at revision had diminished in 19 of the 22 hips at follow-up. We noted a large reduction in bone mineral density. It was most pronounced in Gruen regions 1, 2, 6, and 7.Interpretation Revision with this stem is a reliable procedure; however, we noted a large degree of proximal bone loss that could lead to later mechanical complications or fractures.

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Fixation and Bone Remodeling Around a Low Stiffness Stem in Revision Surgery

Kärrholm¹,

Razaznejad²

2008

Clinical Orthopaedics &Amp; Related Research

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Femoral stems with reduced stiffness have the potential of decreasing stress shielding and could be an alternative in revision surgery when restoration of bone stock is required. We retrospectively reviewed 38 patients (40 stems) with a central core of cobalt-chromium surrounded by a polymer and an outer titanium mesh layer containing a proximal coating of hydroxyapatite/tricalcium phosphate; 30 of the 38 patients (32 hips) had a minimum 2-year followup. We impacted morselized allograft around the stem in 28 of 32 revisions. Repeated radiostereometric examinations showed medial, distal, and posterior migration (median, 0.21 mm, 0.17 mm, and 0.96 mm, respectively) of the femoral head center for up to 6 months followed by stabilization. Measurements of bone mineral density in the seven Gruen zones at 6 months revealed either a decrease (down to a median of 3%), no change, or a slight increase (up to 5%) followed by a further increase up to 2 years in three of the regions (2, 3, and 5). Conventional radiography at 2 years demonstrated graft remodeling and incomplete radiolucent lines in 19 hips, mainly in Regions 1 and 7. Two hips were reoperated on as a result of dislocation, but none of the stems had been revised.

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Zementierte versus unzementierte Revisions-Hüftarthroplastik mit verdichtetem Knochenallograft - Prospektiv randomisierte Vergleichsstudie mit Jahres-Follow-up

Abstract: Cemented technique in hip revisions using morselized bone allograft is as good as uncemented technique in preserving BMD measured by the DEXA method and restoring function in a 5 years follow-up.

Cited by 7 publications

References 15 publications

A Case of Cementless Impaction Bone Graft in a Revision Total Hip Arthroplasty Requiring Calcar Reconstruction

A Case of Cementless Impaction Bone Graft in a Revision Total Hip Arthroplasty Requiring Calcar Reconstruction

Large femoral bone loss after hip revision using the uncemented proximally porous-coated Bi-Metric prosthesis

Fixation and Bone Remodeling Around a Low Stiffness Stem in Revision Surgery

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