The Management of Advanced Lateral Bone Defects with the Splitted Bone Block Technique in the Maxillary and in the Mandible. A Follow-up until 8 Years

Abstract Background The aim of this paper is to evaluate the clinical and radiological outcomes of a fluted tapered modular distal-fixation stem at medium to long-term follow-up. The hypothesis of this investigation was to verify if the use of this implant design may have provided potential advantages in femoral revisions and post-traumatic instances where the restoration of the anatomy was the prime concern. Methods We retrospectively reviewed 62 cases of femoral revision surgeries, performed in Paprosky type IIIA and IIIB bone defects between January 2001 and December 2011 with a mean follow-up of 8.5 ± 1.5 years (range 5.1–15.9 years) where a modular fluted stem was used. The clinical assessment was performed with the Harris Hip Score (HHS), and the radiographic evaluation was carried in order to assess the stability of the femoral component. Intra-operative and postoperative complications were recorded, and the rates of complications and revisions for any cause were determined. Results Mean HHS improved 35.4 points from the preoperative assessment. Radiographic evaluation showed a stable stem anchorage in 90.3% of the cases at the last follow-up. Five (8%) implants required additional surgery. Neither breakage of the stem nor loosening of the taper junction were recorded. Kaplan-Meier survivorship was 89.4% (CI: 88.8–90%) for any complication and 92.3% (CI: 91.8–92.7%) according to revision for any causes at 81 months follow-up. Conclusions Our findings suggest that this stem design is a reliable option in cases of complex femoral bone defects, as well as in cases with high functional deficiencies, with promising survivorship.

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Clinical and radiological outcomes of acetabular revision surgery with trabecular titanium cups in Paprosky type II and III bone defects

Journal of Orthopaedics and Traumatology ◽

10.1186/s10195-021-00571-1 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Loris Perticarini ◽

Stefano Marco Paolo Rossi ◽

Marta Medetti ◽

Francesco Benazzo

Keyword(s):

Revision Surgery ◽

Case Series ◽

Bone Defects ◽

Harris Hip Score ◽

Type Ii ◽

Level Of Evidence ◽

Kaplan Meier ◽

Prospective Case Series ◽

Acetabular Components

Abstract Background This prospective study aims to evaluate the mid-term clinical outcomes and radiographic stability of two different types of cementless trabecular titanium acetabular components in total hip revision surgery. Methods Between December 2008 and February 2017, 104 cup revisions were performed using trabecular titanium revision cups. Mean age of patients was 70 (range 29–90; SD 11) years. The majority of revisions were performed for aseptic loosening (86 cases, 82.69%), but in all the other diagnoses (18 cases), a significant bone loss (Paprosky type II or III) was registered preoperatively. Bone defects were classified according to Paprosky acetabular classification. We observed 53 type II defects and 42 type III defects. Cups were chosen according to the type of defect. Results Average follow-up was 91 (range 24–146) months. Mean Harris Hip Score (HHS) improved from 43.7 (range 25–70; SD 9) preoperatively to 84.4 (range 46–99; SD 7.56) at last follow-up. One (1.05%) cup showed radiographic radiolucent lines inferior to 2 mm and was clinically asymptomatic. One (1.05%) cup was loose and showed periacetabular allograft reabsorption. Kaplan–Meier survivorship was assessed to be 88.54% (95% CI 80.18–93.52%) at 71 months, with failure of the cup for any reason as the endpoint. Conclusion Trabecular titanium revision cups showed good clinical and radiographic results at mid-term follow-up in Paprosky type II and III bone defects. Level of evidence Level IV prospective case series

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Autologous Impaction Bone Grafting for Bone Defects of the Medial Tibia Plateau During Primary Total Knee Arthroplasty: Propensity Score Matched Analysis With a Minimum of 7-Year Follow-Up

The Journal of Arthroplasty ◽

10.1016/j.arth.2018.02.082 ◽

2018 ◽

Vol 33 (8) ◽

pp. 2465-2470 ◽

Cited By ~ 1

Author(s):

Jong M. Sohn ◽

Yong In ◽

Sang H. Jeon ◽

Jin Y. Nho ◽

Man S. Kim

Keyword(s):

Total Knee Arthroplasty ◽

Propensity Score ◽

Knee Arthroplasty ◽

Primary Total Knee Arthroplasty ◽

Bone Defects ◽

Impaction Bone Grafting ◽

Total Knee ◽

Tibia Plateau ◽

Primary Total Knee

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Salvage Arthrodesis with Femoral Head Allograft for Failed Total Ankle Arthroplasty

Foot & Ankle Orthopaedics ◽

10.1177/2473011420s00323 ◽

2020 ◽

Vol 5 (4) ◽

pp. 2473011420S0032

Author(s):

Hong S. Lee ◽

Kiwon Young ◽

Tae-Hoon Park ◽

Hong Seop Lee

Keyword(s):

Femoral Head ◽

Subjective Assessment ◽

Total Ankle Arthroplasty ◽

Bone Block ◽

Ankle Arthroplasty ◽

Pain Scores ◽

Walking Aids ◽

The Mean ◽

Final Followup

Category: Ankle Introduction/Purpose: Failed total ankle arthroplasty (TAA) often results in significant bone loss and requires salvage arthrodesis. The aim of this study was to investigate the outcomes of Salvage arthrodesis with allo-bone block for failed TAA. Methods: This study included 8 patients who underwent salvage arthrodesis with femoral head allograft for failed TAA from August 2012 to March 2018 because of loosing of TAA implant. The mean age of the patients was 71 years (range, 54-81 years), and the mean follow-up period was 32 months (range, 12 to 84 months). Allograft problem and alignment of joint were evaluated radiographically. American Orthopaedic Foot & Ankle Society (AOFAS) scores, Foot and Ankle Outcome Score (FAOS), and visual analogue scale (VAS) pain scores were recorded preoperatively and at the time of final followup. Functional questionnaires were used to assess the duration for which the patient could walk continuously, use of walking aids, consumption of pain medication, and the patient’s subjective assessment of the percentage of overall improvement compared with before the salvage arthrodesis. Results: The allograft was retained without collapse for a mean of 24 months (range, 12 to 36 months) in four patients. Collapse of the allograft was observed in four patients at a mean of 11 months (range, 9 to 16 months), 1 of 4 patients were conserved to retrograde intramedullary nail at postoperative 12 months because of with implant failure and nonunion. The mean AOFAS and VAS pain scores improved from 12 (range, 8 to 40) preoperatively to 63 (range, 38 to 75) postoperatively (p = 0.001) and from 7 (range, 6 to 10 to 3 (range, 2 to 8) (p = 0.001), respectively. At the final follow-up evaluation, 6 of 8 patients were able to walk continuously at least 30 minutes with walking aid. Conclusion: The successful rate of salvage arthrodesis with femoral head allograft was 75% (Six of total 8 patients). The incidence rate of allograft collapse was 50% (Four of total 8 patients).

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Treatment of diaphyseal forearm defects caused by infection using Ilizarov segmental bone transport technique

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03896-w ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Yanshi Liu ◽

Maimaiaili Yushan ◽

Zhenhui Liu ◽

Jialin Liu ◽

Chuang Ma ◽

...

Keyword(s):

Clinical Outcomes ◽

External Fixator ◽

Bone Defects ◽

Bone Transport ◽

Segmental Bone Transport ◽

The Mean ◽

Forearm Bone ◽

Segmental Bone ◽

Transport Technique

Abstract Background The Ilizarov segmental bone transport technique can be applied in the reconstruction of the bone defects with less invasive fashion and more versatility compared to other methods, while most studies were focused on the lower extremity. The purpose of this study was to evaluate the effectiveness of the Ilizarov segmental bone transport technique in the treatment of diaphyseal forearm bone defects caused by infection. Methods This study included 12 patients with diaphyseal forearm bone defects caused by infection, who underwent bone transport procedures using the monolateral external fixator at our institution from January 2010 to January 2018, including 10 males and 2 females with a mean age of 39 years (range 23–57 years). Patient’s demographic data and clinical outcomes at least two years follow-up after removing the external fixator were collected and retrospectively analyzed. The functional results were evaluated by the questionnaire of Disability of Arm, Shoulder and Hand (DASH) and the modified Mayo wrist score (MWS) at the final follow-up. Results There were 10 radii and 2 ulnae bone transport procedures collected. The average defect size was 5.1 cm (4-6.5 cm). All patients were successfully followed up with a mean period of 28.2 months (24 to 36 months) and achieved infection-free union. There was no recurrence of infection observed. The mean external fixation time was 232.6 days (182 to 276 days), and the mean external fixation index was 46.3 days/cm (40.9 to 61.8 days/cm). The mean DASH score was 30.6(18 to 49) preoperative, while 13.8 (5 to 26) at the final follow-up. The average modified MWS improved from 68.8 (55 to 80) pre-operatively to 83.8 (65 to 90) at the final follow-up. All the differences between the preoperative and final scores were statistically significant (p < 0.05). Almost all the patients achieved satisfactory clinical outcomes and were able to perform activities of daily living. Conclusions Ilizarov segmental bone transport technique is an alternative and effective method for the treatment of diaphyseal forearm bone defects caused by infection, and this method acquired satisfactory clinical outcomes.

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Reconstruction of the glenoid using autologous bone-graft and the SMR Axioma TT metal-backed prosthesis

The Bone & Joint Journal ◽

10.1302/0301-620x.100b12.bjj-2018-0494.r1 ◽

2018 ◽

Vol 100-B (12) ◽

pp. 1609-1617 ◽

Cited By ~ 9

Author(s):

A. M. Malhas ◽

J. Granville-Chapman ◽

P. M. Robinson ◽

S. Brookes-Fazakerley ◽

M. Walton ◽

...

Keyword(s):

Bone Graft ◽

Reliable Method ◽

Titanium Surface ◽

Bone Defects ◽

Autologous Bone Graft ◽

Short Term ◽

Bone Deficiency ◽

Autologous Bone ◽

Shoulder Arthroplasties

Aims We present our experience of using a metal-backed prosthesis and autologous bone graft to treat gross glenoid bone deficiency. Patients and Methods A prospective cohort study of the first 45 shoulder arthroplasties using the SMR Axioma Trabecular Titanium (TT) metal-backed glenoid with autologous bone graft. Between May 2013 and December 2014, 45 shoulder arthroplasties were carried out in 44 patients with a mean age of 64 years (35 to 89). The indications were 23 complex primary arthroplasties, 12 to revise a hemiarthroplasty or resurfacing, five for aseptic loosening of the glenoid, and five for infection. Results Of the 45 patients, 16 had anatomical shoulder arthroplasties (ASA) and 29 had reverse shoulder arthroplasties (RSA). Postoperatively, 43/45 patients had a CT scan. In 41 of 43 patients (95%), the glenoid peg achieved > 50% integration. In 40 of 43 cases (93%), the graft was fully or partially integrated. There were seven revisions (16%) but only four (9%) required a change of baseplate. Four (25%) of the 16 ASAs were revised for instability or cuff failure. At two-year radiological follow-up, five of the 41 cases (11%) showed some evidence of lucent lines. Conclusion The use of a metal baseplate with a trabecular titanium surface in conjunction with autologous bone graft is a reliable method of addressing glenoid bone defects in primary and revision RSA setting in the short term. ASAs have a higher rate of complications with this technique.

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Recurrent anterior shoulder dislocation with glenoid fracture managed by modified Boytchev procedure: a rare case report

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20193092 ◽

2019 ◽

Vol 5 (5) ◽

pp. 958

Author(s):

Ashish Devgan ◽

Umesh Yadav ◽

Rajesh Rohilla ◽

Pankaj Sharma ◽

Varun Goel ◽

...

Keyword(s):

Shoulder Dislocation ◽

Full Range ◽

Anterior Dislocation ◽

Bone Block ◽

Anterior Shoulder Dislocation ◽

Glenoid Fracture ◽

Rare Case Report ◽

Muscle Actions ◽

Recurrent Anterior Dislocation

<p class="abstract">Surgical procedures for recurrent anterior dislocation of the shoulder include using capsuloligamentous or bone blocks to create barriers and active interventions using muscle actions. Fracture of glenoid acts as a barrier for bone block procedures. Boytchev procedure, though outmoded, yet acts as simple and effective procedure in this condition. Here we report a 44 year old male with recurrent anterior dislocation with glenoid fracture treated by Boytchev procedure. The patient is on regular follow up since 3 years with no episode of shoulder dislocation till now with full range of movements. To conclude, Boytchev procedure is technically simple and effective method in patients with recurrent anterior shoulder dislocation with fracture of glenoid.</p>

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3D Printing Individualized Assisted Repair and Reconstruction of Irregular Bone Neoplastic Bone Defects: Exploration and Practice in Scapular Aneurysmal Cystic Bone Defects

10.21203/rs.3.rs-477108/v1 ◽

2021 ◽

Author(s):

Guochen Luo ◽

yao Zhang ◽

Xiahua Wang ◽

Shuaishuai Chen ◽

Dongyi Li ◽

...

Keyword(s):

3D Printing ◽

Bone Defect ◽

Bone Tumor ◽

Surgical Approach ◽

Treatment Plan ◽

Operation Time ◽

Bone Defects ◽

Anatomical Structure ◽

Medical Software

Abstract Objective: To explore the clinical efficacy of using 3D printing individualized treatment plan in the auxiliary repair and reconstruction of irregular bone tumor bone defect.Methods：Seven patients with aneurysmal bone cyst of scapula were selected. Based on the CT data of the patient, the scapula (including defect) and pelvis were reconstructed by computer Mimics Medical software. Print out the reconstructed scapula model with a 3D printer. Before operation, the model was used to design the surgical approach and simulate the operation process, to determine the length and Radian of the plate and the number and direction of screws, and to determine the bone mass of the ilium and make reasonable segmentation and distribution. The operation time, the amount of bleeding, the length and Radian of the plate, and the direction and number of screws were recorded.Results : The average follow-up time was 25.6 months, and none of the 7 patients had recurrence during the follow-up period; The surgical approach, the length and Radian of the internal fixation, the number and direction of screws were consistent with the designed operation plan. The anatomical structure of scapula and the function of shoulder joint gradually recovered.Conclusions: Compared with traditional methods, the use of 3D printing technology in the treatment of irregular bone tumor bone defect has less trauma, shorter operation time and less bleeding, which can reduce the waste of bone graft and reconstruct the anatomical structure of bone defect more completely.

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