Preoperative angiography of the iliofemoral vessels in hip revision surgery of massive acetabular bone defects

2000 ◽  
Vol 1 (1) ◽  
pp. 47-50 ◽  
Author(s):  
Pietro Bartolozzi ◽  
Dario Regis
Keyword(s):  
Revision Surgery ◽  
Bone Defects ◽  
Hip Revision ◽  
Acetabular Bone ◽  
Hip Revision Surgery ◽  
Acetabular Bone Defects ◽  
Iliofemoral Vessels

Impaction bone grafting in hip re-revision surgery

2021 ◽  
Vol 103-B (3) ◽  
pp. 492-499
Author(s):  
Eduardo Garcia-Rey ◽  
Laura Saldaña ◽  
Eduardo Garcia-Cimbrelo
Keyword(s):  
Aseptic Loosening ◽  
Acetabular Component ◽  
Revision Surgery ◽  
Bone Grafting ◽  
Bone Defects ◽  
Bone Stock ◽  
Impaction Bone Grafting ◽  
Acetabular Bone ◽  
Acetabular Bone Defects

Aims Bone stock restoration of acetabular bone defects using impaction bone grafting (IBG) in total hip arthroplasty may facilitate future re-revision in the event of failure of the reconstruction. We hypothesized that the acetabular bone defect during re-revision surgery after IBG was smaller than during the previous revision surgery. The clinical and radiological results of re-revisions with repeated use of IBG were also analyzed. Methods In a series of 382 acetabular revisions using IBG and a cemented component, 45 hips (45 patients) that had failed due to aseptic loosening were re-revised between 1992 and 2016. Acetabular bone defects graded according to Paprosky during the first and the re-revision surgery were compared. Clinical and radiological findings were analyzed over time. Survival analysis was performed using a competing risk analysis. Results Intraoperative bone defect during the initial revision included 19 Paprosky type IIIA and 29 Paprosky type IIIB hips; at re-revision, seven hips were Paprosky type II, 27 type IIIA and 11 were type IIIB (p = 0.020). The mean preoperative Harris Hip Score was 45.4 (SD 6.4), becoming 80.7 (SD 12.7) at the final follow-up. In all, 12 hips showed radiological migration of the acetabular component, and three required further revision surgery. The nine-year cumulative failure incidence (nine patients at risk) of the acetabular component for further revision surgery was 9.6% (95% confidence interval (CI) 2.9 to 21.0) for any cause, and 7.5% (95% CI 1.9 to 18.5) for aseptic loosening. Hips with a greater hip height had a higher risk for radiological migration (odds ratio 1.09, 95% CI 1.02 to 1.17; p = 0.008). Conclusion Bone stock restoration can be obtained using IBG in revision hip surgery. This technique is also useful in re-revision surgery; however, a better surgical technique including a closer distance to hip rotation centre could decrease the risk of radiological migration of the acetabular component. A longer follow-up is required to assess potential fixation deterioration. Cite this article: Bone Joint J 2021;103-B(3):492–499.

scholarly journals Theoretical Aspects, Modern Treatment Options and Practical Case Presentations in Hip and Knee Tumoral and Revision Bone Defect Reconstruction Surgery

2019 ◽  
Vol 69 (12) ◽  
pp. 3664-3668
Author(s):  
George Dinache ◽  
Marinel Drignei ◽  
Stergios Ganatsios ◽  
Eric Jovenet ◽  
Radu Costea ◽  
...  
Keyword(s):  
Bone Defect ◽  
Revision Surgery ◽  
Distal Femur ◽  
Treatment Options ◽  
Bone Defects ◽  
Practical Case ◽  
Acetabular Bone ◽  
Acetabular Bone Defects ◽  
Case Presentations ◽  
Bone Defect Reconstruction

Bone defects are a challenge to any and in fact every orthopedic surgeon, be they as a consequence of trauma, peri-implant bone loss as is the case in revision surgery or, more often than not, in tumors of the bone. These defects are in most cases difficult to reconstruct, but even more so in the case when they are located around the major joints of the lower limb, i.e. the hip and the knee. We focus in this article on acetabular bone defects as well as on defects around the knee (distal femur and proximal tibia). We present implant possibilities and modern means of reconstructing the bone defect using augments. We also present three representative cases from our Clinic, to further exemplify the discussed concepts. We present our opinions on reconstructing bone defects after tumor and revision surgery in the hip and knee and we draw conclusions.

scholarly journals Using Tantalum Augments for Major Acetabular Bone Defects in Revision Hip Surgery

2019 ◽  
Vol 2 (2) ◽  
pp. 64-68
Author(s):  
Adrian Cursaru ◽  
Bogdan Şerban ◽  
Alexandru George Lupu ◽  
Dan Anghelescu ◽  
Georgian Iacobescu ◽  
...  
Keyword(s):  
Revision Surgery ◽  
Functional Results ◽  
Bone Defects ◽  
Acetabular Bone ◽  
Rotation Center ◽  
Acetabular Bone Defects ◽  
Harris Score ◽  
Revision Hip Surgery ◽  
Hip Rotation

AbstractAim. The purpose of the study was to follow up the clinical and functional results of the patients with major acetabular bone defects in revision hip surgery.Materials and methods. The study was retrospective, over a period of six years (from January 2014 to January 2019), and included all the patients with hip replacement, with major acetabular bone defects, who needed Tantalum blocks substitution.11 patients were included in the study (8 men and 3 women). The average age was 71 years (between 64 and 78 years old). The average follow up period was 23 months (between 11 and 36 months). Paprosky radiological classification was used for the preoperatory evaluation of the bone defects. In 9 cases, the bone defect was of type 2B Paprosky and in 2 cases, of type 3A. Harris score was determined preoperatory and postoperatory for the appreciation of functional results.Results. 6 patients were underwent replacement for coxarthrosis secondary to dysplasia, 2 patients for coxarthrosis secondary to aseptic necrosis and 3 patients for primary coxarthrosis.The average time elapsed from the moment of primary arthroplasty to the need of revision surgery was on average of 13 years (between 7 and 16 years). The postoperatory radiological evaluation showed an improvement of the hip rotation center from an average postoperative vertical position of 3.1 cm (between 1.2 and 4.6 cm) at an average postoperatory position of 1.1 cm (between 0.5 and 2.3). The average result of Harris score postoperatively was 36 (between 39 and 96). During the follow up period, no early loosening, infection or prosthesis dislocation was registered. Conclusions. The Tantalum Augments used in major acetabular bone defects in revision surgery represent a good option, correcting the hip rotation center, thus considerably improving the functional score.

Major Acetabular Defects Treated with the Burch-Schneider Antiprotrusion Cage and Impaction Bone Allograft in a Large Series: A 5- to 7- Year Follow-up Study

2016 ◽  
Vol 26 (6) ◽  
pp. 585-590 ◽  
Author(s):  
Axel Marx ◽  
Alexander Beier ◽  
Anne Richter ◽  
Christoph H. Lohmann ◽  
Andreas M. Halder
Keyword(s):  
Joint Infection ◽  
Revision Arthroplasty ◽  
Bone Allograft ◽  
Bone Defects ◽  
Harris Hip Score ◽  
Consecutive Series ◽  
Hip Revision ◽  
Acetabular Bone ◽  
Acetabular Bone Defects

Introduction Major bone defects are the greatest challenge in hip revision arthroplasty. Methods In a prospective, consecutive nonrandomised study we followed up 74 patients with Type III (AAOS) acetabular bone defects who underwent revision hip arthroplasty with bone grafting and implantation of a Burch-Schneider anti-protrusion cage (APC). The patients were examined pre- and postoperatively according to a standardised clinical and radiological protocol. No patient was lost to follow-up. Results 9 patients died before follow-up. In 9 other patients the APC was revised within the follow-up period. In 4 of these patients the revision was necessary because of aseptic loosening. In the remaining 5 cases joint infection, recurrent dislocation and 1 trauma were the reasons for revision. 56 patients were included in the statistical analysis. In the follow-up group the mean Harris Hip Score increased from 39.9 preoperatively to 73.2. 85% of the patients assessed their operation result as good or excellent. Conclusions In a large consecutive series the Burch-Schneider anti-protrusion cage proved to be a valuable option in the treatment of major acetabular bone defects in hip revision surgery.

The use of customized cages in revision total hip arthroplasty for Paprosky type III acetabular bone defects

2015 ◽  
Vol 39 (10) ◽  
pp. 2023-2030 ◽  
Author(s):  
Yuanqing Mao ◽  
Chen Xu ◽  
Jiawei Xu ◽  
Huiwu Li ◽  
Fengxiang Liu ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Bone Defects ◽  
Revision Total Hip Arthroplasty ◽  
Acetabular Bone ◽  
Total Hip ◽  
Type Iii ◽  
Acetabular Bone Defects

Porous metal revision shells for management of contained acetabular bone defects at a mean follow-up of six years

2012 ◽  
Vol 94-B (2) ◽  
pp. 158-162 ◽  
Author(s):  
A. Sternheim ◽  
D. Backstein ◽  
P. R. T. Kuzyk ◽  
G. Goshua ◽  
Y. Berkovich ◽  
...  
Keyword(s):  
Porous Metal ◽  
Bone Defects ◽  
Acetabular Bone ◽  
Acetabular Bone Defects

scholarly journals Stem modularity alone is not effective in reducing dislocation rate in hip revision surgery

2009 ◽  
Vol 10 (4) ◽  
pp. 167-171 ◽  
Author(s):  
Dario Regis ◽  
Andrea Sandri ◽  
Pietro Bartolozzi
Keyword(s):  
Revision Surgery ◽  
Dislocation Rate ◽  
Hip Revision ◽  
Hip Revision Surgery
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