The Influence of Liquids on the Mechanical Properties of Allografts in 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.

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Acetabular Revision in Total Hip Arthroplasty Using Bone Impaction Grafting and Cement

European Surgical Orthopaedics and Traumatology ◽

10.1007/978-3-642-34746-7_246 ◽

2014 ◽

pp. 2573-2582

Author(s):

W. H. C. Rijnen ◽

J. W. M. Gardeniers ◽

P. Buma ◽

B. W. Schreurs

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Acetabular Revision ◽

Impaction Grafting ◽

Total Hip ◽

Bone Impaction Grafting

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Proximal Femoral Reconstructions with Bone Impaction Grafting and Metal Mesh

Clinical Orthopaedics and Related Research ◽

10.1007/s11999-009-0777-y ◽

2009 ◽

Vol 467 (9) ◽

pp. 2325-2334 ◽

Cited By ~ 17

Author(s):

Martín A. Buttaro ◽

Fernando Comba ◽

Francisco Piccaluga

Keyword(s):

Impaction Grafting ◽

Metal Mesh ◽

Bone Impaction Grafting

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Good implant survival after acetabular revision with extensive impaction bone grafting and uncemented components

The Bone & Joint Journal ◽

10.1302/0301-620x.102b2.bjj-2019-0584.r2 ◽

2020 ◽

Vol 102-B (2) ◽

pp. 198-204

Author(s):

Rico Perlbach ◽

Lars Palm ◽

Maziar Mohaddes ◽

Ingemar Ivarsson ◽

Jörg Schilcher

Keyword(s):

Acetabular Revision ◽

Impaction Grafting ◽

Implant Survival ◽

Bone Contact ◽

Term Survival ◽

Kaplan Meier ◽

Number Of Patients ◽

Bone Impaction Grafting

Aims This single-centre observational study aimed to describe the results of extensive bone impaction grafting of the whole acetabular cavity in combination with an uncemented component in acetabular revisions performed in a standardized manner since 1993. Methods Between 1993 and 2013, 370 patients with a median age of 72 years (interquartile range (IQR) 63 to 79 years) underwent acetabular revision surgery. Of these, 229 were more than ten years following surgery and 137 were more than 15 years. All revisions were performed with extensive use of morcellized allograft firmly impacted into the entire acetabular cavity, followed by insertion of an uncemented component with supplementary screw fixation. All types of reoperation were captured using review of radiographs and medical charts, combined with data from the local surgical register and the Swedish Hip Arthroplasty Register. Results Among patients with possible follow-up of ten and 15 years, 152 and 72 patients remained alive without revision of the acetabular component. The number of deaths was 61 and 50, respectively. Of those who died, six patients in each group had a reoperation performed before death. The number of patients with a reoperation was 22 for those with ten-year follow-up and 21 for those with 15 years of follow-up. The Kaplan-Meier implant survival rate for aseptic loosening among all 370 patients in the cohort was 96.3% (95% confidence interval (CI) 94.1 to 98.5) after ten years and 92.8% (95% CI 89.2 to 96.6) after 15 years. Conclusion Extensive bone impaction grafting combined with uncemented revision components appears to be a reliable method with favourable long-term survival. This technique offers the advantage of bone stock restoration and disputes the long-standing perception that uncemented components require > 50% of host bone contact for successful implant survival. Cite this article: Bone Joint J 2020;102-B(2):198–204.

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Bone Impaction Grafting of the Lateral Femoral Condyle in a Pediatric Patient

Orthopedics ◽

10.3928/01477447-20120919-25 ◽

2012 ◽

Vol 35 (10) ◽

pp. e1533-e1536 ◽

Cited By ~ 9

Author(s):

Jimmy J. Jiang ◽

Waqas M. Hussain ◽

Robert J. Bielski

Keyword(s):

Pediatric Patient ◽

Femoral Condyle ◽

Lateral Femoral Condyle ◽

Impaction Grafting ◽

Bone Impaction Grafting

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Acetabular Bone Impaction Grafting

Impaction Bone Grafting in Revision Arthroplasty ◽

10.4324/9780203913680-22 ◽

2004 ◽

pp. 294-305

Keyword(s):

Impaction Grafting ◽

Acetabular Bone ◽

Bone Impaction Grafting

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Midterm survival analysis of a cemented dual-mobility cup combined with bone impaction grafting in 102 revision hip arthroplasties

Hip International ◽

10.5301/hipint.5000548 ◽

2017 ◽

Vol 28 (2) ◽

pp. 161-167 ◽

Cited By ~ 2

Author(s):

Elsa A. Spaans ◽

Koen L.M. Koenraadt ◽

Robert Wagenmakers ◽

Joost A.A.M. van den Hout ◽

Martijn A.J. te Stroet ◽

...

Keyword(s):

Hip Arthroplasty ◽

Dislocation Rate ◽

Control Group ◽

Impaction Grafting ◽

Dual Mobility Cup ◽

Chi Square ◽

Dual Mobility ◽

Combined Control ◽

Bone Impaction Grafting ◽

Hip Arthroplasties

Introduction: Revision hip arthroplasty is associated with higher dislocation rates than primary hip arthroplasty. A dual-mobility cup (DMC) can reduce this risk. Another problem is destruction of the acetabulum, induced by aseptic loosening of the prosthesis. Bone impaction grafting (BIG) can be used to reconstruct these defects, but is usually performed with cemented all polyethylene cups. The purpose of this study is to evaluate midterm cup survival and dislocation rate for the combination of BIG and DMC. Methods: Between 2007 and 2013, 96 patients received 102 DMCs combined with BIG of the acetabulum during revision surgery. These data were first compared with a control group, consisting of 59 cases from the same hospital receiving a cemented all polyethylene cup combined with BIG. In addition, the control group was expanded with 41 cases operated on in 2007 in ‘an orthopaedic centre of excellence’, resulting in a ‘combined control group’ of 100 patients. Log-rank tests and chi-square tests were used to compare survival and dislocation rates, respectively. Results: Cumulative survival of the DMC was 95.8% (range 3 months-7 years). This was comparable to the survival in the control groups (96.5% and 94.7%). The dislocation rate of 2.9% (3/102) in the dual-mobility group was lower (p = 0.02) compared to the dislocation rate of 11.8% (7/59) in the control group, but not (p = 0.12) compared to 8% in the combined control group (8/100). Conclusions: This study shows that combining a DMC with BIG does not compromise outcome in terms of midterm survival of the cup.

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