Acetabular revision with impaction bone grafting and a cemented polyethylene acetabular component

2015 ◽  
Vol 97-B (10) ◽  
pp. 1338-1344 ◽  
Author(s):  
M. A. J. te Stroet ◽  
J. C. Keurentjes ◽  
W. H. C. Rijnen ◽  
J. W. M. Gardeniers ◽  
N. Verdonschot ◽  
...  
Keyword(s):  
Acetabular Component ◽  
Bone Grafting ◽  
Acetabular Revision ◽  
Impaction Bone Grafting

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.

Acetabular Revision in THA Using Tantalum Augments Combined with Impaction Bone Grafting

2013 ◽  
Vol 23 (4) ◽  
pp. 359-365 ◽  
Author(s):  
Thorsten Gehrke ◽  
Yannic Bangert ◽  
Bernd Schwantes ◽  
Matthias Gebauer ◽  
Daniel Kendoff
Keyword(s):  
Bone Grafting ◽  
Acetabular Revision ◽  
Impaction Bone Grafting

Use of Irradiated Bone Graft for Impaction Grafting in Acetabular Revision Surgery: A Review of Fifty Consecutive Cases

2009 ◽  
Vol 19 (2) ◽  
pp. 114-119 ◽  
Author(s):  
Sanchit Mehendale ◽  
Ian D. Learmonth ◽  
Evert J. Smith ◽  
Suneel Nedungayil ◽  
Rohit Maheshwari ◽  
...  
Keyword(s):  
Bone Graft ◽  
Revision Surgery ◽  
Bone Grafting ◽  
Recurrent Dislocation ◽  
Acetabular Revision ◽  
Consecutive Series ◽  
Impaction Bone Grafting ◽  
Excellent Outcome ◽  
Fresh Frozen ◽  
Paprosky Classification

Impaction bone grafting is a useful technique in the armament of a revision hip surgeon. Traditionally fresh frozen allograft has been used for this technique. However there are concerns about the transmission of viral proteins and prions through this form of allograft. As a result irradiated bone graft has been favoured in some centres. There is no long term series describing the results of impaction bone grafting using irradiated bone. This paper reviews a consecutive series of 50 cases of acetabular revision surgery performed between 1995 and 2001 and followed up over a mean period of 45 months. The preoperative bone defect was graded by the Paprosky classification. There were 2 cases of type 1a, 9 type 2a, 15 type 2b, 7 type 2c, 10 type 3a and 7 type 3b. All cases were followed up clinically and radiologically. Case notes were reviewed for primary prosthesis, operative details and reason for revision. The radiographs were evaluated for signs of bone incorporation, remodelling, loosening and migration of the acetabular component. There were 5 cases of aseptic loosening at the end of the follow up period. One patient had recurrent dislocation and was revised. 20 cases (40%) showed changes suggestive of bone incorporation, while only 3 cases (6%) showed remodelling. Clinically a good or excellent outcome with absence of pain was achieved in 35 patients (70%). The results suggested that acetabular impaction bone grafting using irradiated bone graft is comparable to fresh frozen allograft. The low percentage of remodelling remains a concern and warrants further studies.

scholarly journals Acetabular revision with impacted morsellised cancellous bone grafting and a cemented acetabular component

2009 ◽  
Vol 91-B (9) ◽  
pp. 1148-1153 ◽  
Author(s):  
B. W. Schreurs ◽  
J. C. Keurentjes ◽  
J. W. M. Gardeniers ◽  
N. Verdonschot ◽  
T. J. J. H. Slooff ◽  
...  
Keyword(s):  
Acetabular Component ◽  
Cancellous Bone ◽  
Bone Grafting ◽  
Acetabular Revision ◽  
Cancellous Bone Grafting

The Biological Approach in Acetabular Revision Surgery: Impaction Bone Grafting and a Cemented Cup

2015 ◽  
Vol 25 (4) ◽  
pp. 361-367 ◽  
Author(s):  
Ena Colo ◽  
Wim H.C. Rijnen ◽  
Berend Willem Schreurs
Keyword(s):  
Revision Surgery ◽  
Bone Grafting ◽  
Acetabular Revision ◽  
Impaction Bone Grafting ◽  
Biological Approach ◽  
Cemented Cup

scholarly journals Acetabular Revision with Metal Mesh, Impaction Bone Grafting, and a Cemented Cup

2008 ◽  
Vol 466 (10) ◽  
pp. 2482-2490 ◽  
Author(s):  
Martín A. Buttaro ◽  
Fernando Comba ◽  
Rodolfo Pusso ◽  
Francisco Piccaluga
Keyword(s):  
Bone Grafting ◽  
Acetabular Revision ◽  
Impaction Bone Grafting ◽  
Metal Mesh ◽  
Cemented Cup

scholarly journals Effect of synthetic bone replacement material of different size on shear stress resistance within impacted native and thermodisinfected cancellous bone: an in vitro femoral impaction bone grafting model

2021 ◽  
Author(s):  
C. Fölsch ◽  
P. Sahm ◽  
C. A. Fonseca Ulloa ◽  
G. A. Krombach ◽  
M. Kampschulte ◽  
...  
Keyword(s):  
Cancellous Bone ◽  
Bone Grafting ◽  
Shear Force ◽  
Distal Region ◽  
Impaction Bone Grafting ◽  
Proximal Point ◽  
Local Antibiotics ◽  
Joint Replacements ◽  
Native Bone

AbstractAntibiotic carrier particles of variable size might influence mechanic properties within impacted thermodisinfected and native cancellous bone different. Herafill®G containing calciumsulfate and calciumcarbonate provides high local concentrations of gentamicin being important for revision surgery in infected joint replacements. Native and thermodisinfected cancellous bone derived from 6 to 7 months old piglets was used for in vitro impaction bone grafting and supplemented each with Herafill®G granules of two different sizes. Micromovement of implants related to shear force was measured in 29 specimens distributed in 6 groups. Thermodisinfected cancellous bone revealed a significant higher shear force resistance than native bone with a mean difference of 423.8 mdeg/Nm (p < 0.001) ranging within 95% confidence interval from 181.5 to 666.0 mdeg/Nm. Adding small granules to thermodisinfected bone did not reduce shear force resistance significantly since adding large granules to native bone improved it by 344.0 mdeg/Nm (p < 0.003). Shear force resistance was found higher at the distal region of the implant compared to a proximal point of measurement throughout all specimens. Less impaction impulses were necessary for thermodisinfected bone. Thermodisinfected cancellous bone might achieve a higher degree of impaction compared with native bone resulting in increased resistance against shear force since impaction was found increased distally. Supplementation of thermodisinfected bone with small granules of Herafill®G might be considered for application of local antibiotics. Large granules appeared more beneficial for supplementation of native bone. Heterogeneity of bone graft and technical aspects of the impaction procedure have to be considered regarding the reproducibility of femoral impaction bone grafting.

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