Five-year Follow-up of Socket Movements and Loosening After Revision With Impacted Morselized Allograft Bone and Cement

2006 ◽  
Vol 21 (7) ◽  
pp. 975-984 ◽  
Author(s):  
Ewald Ornstein ◽  
Herbert Franzén ◽  
Ragnar Johnsson ◽  
Anna Stefánsdóttir ◽  
Martin Sundberg ◽  
...  
Keyword(s):  
Allograft Bone ◽  
Morselized Allograft

Long-term results of acetabular reconstruction using irradiated allograft bone

2018 ◽  
Vol 100-B (11) ◽  
pp. 1449-1454 ◽  
Author(s):  
C. M. Green ◽  
S. C. Buckley ◽  
A. J. Hamer ◽  
R. M. Kerry ◽  
T. P. Harrison
Keyword(s):  
At Risk ◽  
Aseptic Loosening ◽  
Acetabular Component ◽  
Long Term Results ◽  
Acetabular Reconstruction ◽  
Allograft Bone ◽  
Patients At Risk ◽  
Irradiated Allograft

Aims The management of acetabular defects at the time of revision hip arthroplasty surgery is a challenge. This study presents the results of a long-term follow-up study of the use of irradiated allograft bone in acetabular reconstruction. Patients and Methods Between 1990 and 2000, 123 hips in 110 patients underwent acetabular reconstruction for aseptic loosening, using impaction bone grafting with frozen, irradiated, and morsellized femoral heads and a cemented acetabular component. A total of 55 men and 55 women with a mean age of 64.3 years (26 to 97) at the time of revision surgery are included in this study. Results At a mean follow-up of 16.9 years, there had been 23 revisions (18.7%), including ten for infection, eight for aseptic loosening, and three for dislocation. Of the 66 surviving hips (58 patients) that could be reassessed, 50 hips (42 patients; 75.6%) were still functioning satisfactorily. Union of the graft had occurred in all hips with a surviving implant. Survival analysis for all indications was 80.6% at 15 years (55 patients at risk, 95% confidence interval (CI) 71.1 to 87.2) and 73.7% at 20 years (eight patients at risk, 95% CI 61.6 to 82.5). Conclusion Acetabular reconstruction using frozen, irradiated, and morsellized allograft bone and a cemented acetabular component is an effective method of treatment. It gives satisfactory long-term results and is comparable to other types of reconstruction. Cite this article: Bone Joint J 2018;100-B:1449–54.

scholarly journals The Use of Patient-Specific 3D Printed Titanium Implants for Complex Foot and Ankle Limb Salvage, Deformity Correction, and Arthrodesis Procedures

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0000
Author(s):  
Samuel Adams ◽  
Travis Dekker ◽  
John Steele ◽  
Kamran Hamid
Keyword(s):  
Lower Extremity ◽  
Deformity Correction ◽  
Titanium Implants ◽  
Patient Specific ◽  
Allograft Bone ◽  
Foot And Ankle ◽  
Sf 36 ◽  
3D Printed ◽  
The Mean

Category: Ankle,Ankle Arthritis,Basic Sciences/Biologics,Trauma Introduction/Purpose: Large lower extremity bony defects, complex foot and ankle deformities, and high-risk arthrodesis situations can be difficult to treat. These challenging pathologies, often require a critical-sizes and/or shaped structural bone void filler which may not be available with allograft bone. The advancement of 3D printing technology has allowed for the use of custom designed implants for foot and ankle surgery. This study reports on the radiographic and functional outcomes of a case series of patients treated with patient-specific 3D printed titanium implants. Methods: Seven consecutive patients who were treated with custom designed 3D printed implant cages for severe bone loss, deformity correction, and arthrodesis procedures were included in this study. A minimum of 1-year follow-up was required. No patients were lost to follow-up. Patients completed preoperative and most recent follow-up VAS for pain, FAAM, and SF-36 outcomes questionnaires. All patients had post-operative radiographs and CT scans to assess bony incorporation. Results: The mean age of these patients was 54.6 (35-73 years of age). The mean follow-up of these seven patients was 17.1 months (range 12 to 31). Radiographic fusion with cage ingrowth and integration occurred in all seven patients verified by CT scan. There was statistically significant improvement in all functional outcome score measures (VAS for pain, FAAM, and SF-36). All patients returned were satisfied with surgery. There were no failures. Case examples are demonstrated in Figure 1. Conclusion: This cohort of patients demonstrated the successful use of custom 3D printed implants to treat complex large bony defects, deformities and arthrodesis procedures of the lower extremity. These implants offer the surgeon a patient specific approach to treat both pain and deformity that is not necessarily available with allograft bone.

Locally administered bisphosphonate in hip stem revisions using the bone impaction grafting technique: a randomised, placebo-controlled study with DXA and five-year RSA follow-up

2018 ◽  
Vol 29 (1) ◽  
pp. 26-34
Author(s):  
Ola Belfrage ◽  
Magnus Tägil ◽  
Martin Sundberg ◽  
Uldis Kesteris ◽  
Gunnar Flivik
Keyword(s):  
Bone Density ◽  
Femoral Stem ◽  
Controlled Study ◽  
First Year ◽  
Allograft Bone ◽  
Impaction Grafting ◽  
Hip Revision ◽  
Grafting Technique ◽  
Bone Impaction Grafting

Background: Bisphosphonates have previously been shown to increase the density of impacted graft bone. In the present study we hypothesise that bisphosphonates also reduce early stem subsidence. We examined the effect of locally applied bisphosphonate to allografts on prosthetic micromotion and bone density in femoral stem revision with impaction grafting. Methods: 37 patients were randomised to either clodronate or saline as local adjunct to the morsellised allograft bone. 24 patients were finally analysed per protocol and evaluated by dual-energy x-ray absorptiometry (DXA) during the first year and with radiostereometric analysis (RSA) for 5 years. Results: There were no significant differences neither in bone density, nor in migratory behaviour between the groups. The femoral stems had subsided 3.6 mm in both groups (p = 0.99) at 5 years and there was no difference as measured over time with mixed models analysis. The clinical outcome was good in both groups. Conclusion: Clodronate as a local addendum to allograft bone in hip revision did not increase bone density or reduce micromotion of the implant.

The effect of pretreating morselized allograft bone with rhBMP-2 and/or pamidronate on the fixation of porous Ti and HA-coated implants

Biomaterials ◽  
2008 ◽  
Vol 29 (19) ◽  
pp. 2915-2922 ◽  
Author(s):  
Jorgen Baas ◽  
Brian Elmengaard ◽  
Thomas B. Jensen ◽  
Thomas Jakobsen ◽  
Niels T. Andersen ◽  
...  
Keyword(s):  
Allograft Bone ◽  
Porous Ti ◽  
Morselized Allograft

Total L-5 spondylectomy and reconstruction of the lumbosacral junction

2007 ◽  
Vol 7 (1) ◽  
pp. 103-111 ◽  
Author(s):  
Gary L. Gallia ◽  
Daniel M. Sciubba ◽  
Ali Bydon ◽  
Ian Suk ◽  
Jean-Paul Wolinsky ◽  
...  
Keyword(s):  
Vertebral Body ◽  
Anterior Approach ◽  
Posterior Approach ◽  
Pedicle Screws ◽  
Allograft Bone ◽  
Lumbosacral Junction ◽  
Second Stage ◽  
Iliac Screws ◽  
Vascular Structures

✓The authors describe a technique for total L-5 spondylectomy and reconstruction of the lumbosacral junction. The technique, which involves separately staged posterior and anterior procedures, is reported in two patients harboring neoplasms that involved the L-5 level. The first stage consisted of a posterior approach with removal of all posterior bone elements of L-5 and radical L4–5 and L5–S1 discectomies. Lumbosacral and lumbopelvic instrumentation included pedicle screws as well as iliac screws or a transiliac rod. The second stage consisted of an anterior approach with mobilization of vascular structures, completion of L4–5 and L5–S1 discectomies, and removal of the L-5 vertebral body. Anterior lumbosacral reconstruction included placement of a distractable cage and tension band between L-4 and S-1. Allograft bone was used for fusion in both stages. No significant complications were encountered. At more than 1 year of follow-up, both patients were independently ambulatory, without evidence of recurrent or metastatic disease, and adequate lumbosacral alignment was maintained. The authors conclude that this technique can be safely performed in appropriately selected patients with neoplasms involving L-5.

scholarly journals Single-stage posterior-only debridement, decompression and interbody fusion for the treatment of thoracolumbar spinal tuberculosis complicated with psoas abscesses

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wence Wu ◽  
Zhechen Li ◽  
Renqin Lin ◽  
Shenglin Wang ◽  
Jianhua Lin
Keyword(s):  
Blood Loss ◽  
Cobb Angle ◽  
Interbody Fusion ◽  
Spinal Tuberculosis ◽  
Operating Time ◽  
Single Stage ◽  
Allograft Bone ◽  
Titanium Mesh ◽  
Thoracolumbar Spinal Tuberculosis

Abstract Background To explore the clinical safety and efficacy of single-stage posterior-only debridement, decompression, allograft bone using titanium mesh and interbody fusion combined for the treatment of thoracolumbar spinal tuberculosis complicated with psoas abscesses. Methods A total of 38 patients diagnosed with thoracolumbar spinal tuberculosis complicated with psoas abscesses underwent surgery via single-stage posterior-only debridement, decompression, allograft bone using titanium mesh and interbody fusion from January 2010 to September 2016 were enrolled in the study. The clinical efficacy of the approach was assessed based on parameters including operating time, blood loss, Cobb angle, visual analogue scale (VAS) scores, Frankel grade, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Results The surgery duration was 224.4 ± 71.1 min with a blood loss of 731.8 ± 585.8 ml. The Cobb angle was corrected from 16.0 ± 15.4° preoperatively to 8.1 ± 7.4° postoperatively (P < 0.001, t = − 4.38), and returned to a level of 11.0 ± 8.5° at the final follow-up (P = 0.002, t = 3.38). Back pain was relieved, with the mean preoperative VAS of 3.5 ± 1.1 decreased to 0.7 ± 0.8 postoperatively (P < 0.001, t = 23.21) and then to 0.6 ± 0.5 at the final follow-up (P < 0.001, t = 17.07). Neurological function was improved in various degrees and psoas abscesses disappeared in all patients. The ESR and CRP decreased gradually after surgery and returned to normal at the final follow-up in all patients. All patients achieved bone fusion thoroughly and no recurrence of TB or surgical related complications was found at the final follow-up. Conclusion Single-stage posterior-only debridement, decompression, allograft bone using titanium mesh and interbody fusion is a safe and effective approach for the management of thoracolumbar spinal tuberculosis complicated with psoas abscesses.

scholarly journals Single-stage posterior-only debridement, decompression, allograft bone using titanium mesh and interbody fusion for the treatment of thoracolumbar spinal tuberculosis complicated with psoas abscesses

2020 ◽  
Author(s):  
Wence Wu ◽  
Zhechen Li ◽  
Renqin Lin ◽  
Shenglin Wang ◽  
Jianhua Lin
Keyword(s):  
Blood Loss ◽  
Cobb Angle ◽  
Interbody Fusion ◽  
Spinal Tuberculosis ◽  
Operating Time ◽  
Single Stage ◽  
Allograft Bone ◽  
Titanium Mesh ◽  
Thoracolumbar Spinal Tuberculosis

Abstract Background: To explore the clinical safety and efficacy of single-stage posterior-only debridement, decompression, allograft bone using titanium mesh and interbody fusion combined for the treatment of thoracolumbar spinal tuberculosis complicated with psoas abscesses.Methods: A total of 38 patients diagnosed with thoracolumbar spinal tuberculosis complicated with psoas abscesses underwent surgery via single-stage posterior-only debridement, decompression, allograft bone using titanium mesh and interbody fusion from January 2010 to September 2016 were enrolled in the study. The clinical efficacy of the approach was assessed based on parameters including operating time, blood loss, Cobb angle, visual analogue scale (VAS) scores, Frankel grade, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP).Results: The surgery duration was 224.4 ± 71.1 min with a blood loss of 731.8 ± 585.8 ml. The Cobb angle was corrected from 16.0 ± 15.4° preoperatively to 8.1 ± 7.4° postoperatively (P < 0.001, t = -4.38), and returned to a level of 11.0 ± 8.5° at the final follow-up (P = 0.002, t = 3.38). Back pain was relieved, with the mean preoperative VAS of 3.5 ± 1.1 decreased to 0.7 ± 0.8 postoperatively (P < 0.001, t = 23.21) and then to 0.6 ± 0.5 at the final follow-up (P < 0.001, t = 17.07). Neurological function was improved in various degrees and psoas abscesses disappeared in all patients. The ESR and CRP decreased gradually after surgery and returned to normal at the final follow-up in all patients. All patients achieved bone fusion thoroughly and no recurrence of TB or surgical related complications was found at the final follow-up. Conclusion: Single-stage posterior-only debridement, decompression, allograft bone using titanium mesh and interbody fusion is a safe and effective approach for the management of thoracolumbar spinal tuberculosis complicated with psoas abscesses.

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