scholarly journals Results of Bone Plasty with Allografts in Revision Hip Arthroplasty

2014 ◽  
Vol 21 (2) ◽  
pp. 33-39
Author(s):  
N. V Zagorodniy ◽  
V. I Nuzhdin ◽  
K. M Bukhtin ◽  
S. V Kagramanov
Keyword(s):  
Hip Arthroplasty ◽  
Revision Arthroplasty ◽  
Bone Defects ◽  
Revision Hip Arthroplasty ◽  
Treatment Results ◽  
Group I ◽  
Group Ii ◽  
Distal Fixation ◽  
Hip Arthroplasties

Results of 79 revision hip arthroplasties using bone defects plasty with allografts were analyzed. Plasty of defects in the zone of acetabulum was performed in 62 operations (group I), alloplasty of femoral defects - in 17 interventions (group II). Mean follow up period made up 5 (3-14) years. In group I excellent treatment results were recorded in 18 (29.03%) cases, good - in 23 (37.1%), satisfactory - in 15 (24.19%), poor - in 6 (9.68%) cases and in II group in 4 (23.53%), 6 (35.29%), 5 (29.41%) and 2 (11.76%) cases, respectively. It was shown that in revision arthroplasty application of allografts increased the risk of suppurative complication development while insertion of distal fixation revision stems enabled to avoid allograft application in femoral defects.

scholarly journals Results of Bone Plasty with Allografts in Revision Hip Arthroplasty

2014 ◽  
pp. 33-39 ◽  
Author(s):  
N. V. Zagorodniy ◽  
V. I. Nuzhdin ◽  
K. M. Bukhtin ◽  
S. V. Kagramanov
Keyword(s):  
Hip Arthroplasty ◽  
Revision Arthroplasty ◽  
Bone Defects ◽  
Revision Hip Arthroplasty ◽  
Treatment Results ◽  
Group I ◽  
Group Ii ◽  
Distal Fixation ◽  
Hip Arthroplasties

Results of 79 revision hip arthroplasties using bone defects plasty with allografts were analyzed. Plasty of defects in the zone of acetabulum was performed in 62 operations (group I), alloplasty of femoral defects - in 17 interventions (group II). Mean follow up period made up 5 (3-14) years. In group I excellent treatment results were recorded in 18 (29.03%) cases, good - in 23 (37.1%), satisfactory - in 15 (24.19%), poor - in 6 (9.68%) cases and in II group in 4 (23.53%), 6 (35.29%), 5 (29.41%) and 2 (11.76%) cases, respectively. It was shown that in revision arthroplasty application of allografts increased the risk of suppurative complication development while insertion of distal fixation revision stems enabled to avoid allograft application in femoral defects.

scholarly journals Experience in the use of Distal Fixation Femoral Component Use in Revision Hip Arthroplasty

2017 ◽  
pp. 27-31
Author(s):  
N. V. Zagorodniy ◽  
A. V. Ivanov ◽  
S. V. Kagramanov ◽  
G. A. Chragyan ◽  
I. A. Nikolaev
Keyword(s):  
Femoral Component ◽  
Hip Arthroplasty ◽  
Weight Bearing ◽  
Revision Arthroplasty ◽  
Pain Syndrome ◽  
Revision Hip Arthroplasty ◽  
Treatment Results ◽  
Distal Fixation ◽  
Component Revision

Purpose. To evaluate the efficacy of revision hip arthroplasty with use of distal fixation revision femoral component.Patients and methods. From June 2004 through October 2015 one hundred thirteen revision arthroplasties were performed in patients with type 3A, 3B and 4 femoral defects by Paprovsky classification. Solution, Wagner SL and Cerafit revision femoral components for distal fixation were used. In the majority of cases (87) the cause of revision intervention was aseptic instability of the femoral component. In 60 cases revision was performed for cementless femoral components, in 53 - for cement components.Results.Follow up period made up from 1 to 12 years. In 83.2% of cases excellent, good and satisfactory treatment results, i.e. pain syndrome remission, restoration of joint movements and extremity weight bearing ability were achieved.Conclusion.Wagner SL, Solution and Cerafit modular revision stems ensure acceptable clinical treatment results and can be the implants of choice for hip femoral component revision arthroplasty in types 3A, 3B and 4 femoral defects by Paprovsky.

scholarly journals Experience in the use of Distal Fixation Femoral Component Use in Revision Hip Arthroplasty

2017 ◽  
Vol 24 (1) ◽  
pp. 27-31
Author(s):  
N. V Zagorodniy ◽  
A. V Ivanov ◽  
S. V Kagramanov ◽  
G. A Chragyan ◽  
I. A Nikolaev
Keyword(s):  
Femoral Component ◽  
Hip Arthroplasty ◽  
Weight Bearing ◽  
Revision Arthroplasty ◽  
Pain Syndrome ◽  
Revision Hip Arthroplasty ◽  
Treatment Results ◽  
Distal Fixation ◽  
Component Revision

Purpose . To evaluate the efficacy of revision hip arthroplasty with use of distal fixation revision femoral component. Patients and methods. From June 2004 through October 2015 one hundred thirteen revision arthroplasties were performed in patients with type 3A, 3B and 4 femoral defects by Paprovsky classification. Solution, Wagner SL and Cerafit revision femoral components for distal fixation were used. In the majority of cases (87) the cause of revision intervention was aseptic instability of the femoral component. In 60 cases revision was performed for cementless femoral components, in 53 - for cement components. Results. Follow up period made up from 1 to 12 years. In 83.2% of cases excellent, good and satisfactory treatment results, i.e. pain syndrome remission, restoration of joint movements and extremity weight bearing ability were achieved. Conclusion. Wagner SL, Solution and Cerafit modular revision stems ensure acceptable clinical treatment results and can be the implants of choice for hip femoral component revision arthroplasty in types 3A, 3B and 4 femoral defects by Paprovsky.

scholarly journals What Characteristics of the Acetabular Defect Influence the Choice of the Acetabular Component During Revision Hip Arthroplasty?

2020 ◽  
Vol 26 (2) ◽  
pp. 31-49
Author(s):  
R. M. Tikhilov ◽  
A. A. Dzhavadov ◽  
A. N. Kovalenko ◽  
A. O. Denisov ◽  
A. S. Demin ◽  
...  
Keyword(s):  
Hip Arthroplasty ◽  
Retrospective Cohort ◽  
Defect Formation ◽  
Bone Defects ◽  
Revision Hip Arthroplasty ◽  
Acetabular Defects ◽  
Type 3 ◽  
Revision Operations

The purposes of the retrospective cohort study were: 1) to determine the severity of defects in the acetabulum and the probable causes of their formation in patients who underwent revision hip arthroplasty (RHA), as well as an assessment of factors that exacerbate the severity of the defects; 2) identifying the proportion of severe defects in the overall structure of acetabular revisions and determining the effectiveness of using serial implants in comparison with individual constructions made by 3D printing; 3) the rationale for rational indications for the use of individual constructions.Materials and Methods. The structure and reasons for the formation of bone defects in the acetabulum were evaluated in 726 cases of revisions performed from 2004 to 2018. In addition, the results of revision operations in a group of patients with severe defects (type 3 according to Paprosky and pelvic discontinuity) were evaluated.Results. The most frequent cause of defect formation was iatrogenic (53.2%), and the share of severe defects was 39.5% (287 observations). A factor aggravating the severity of the defect is the lack of its limitation by the support bone. The results of RHA in patients with severe defects were assessed in 186 cases out of 287 (64.8%). In 73 (39.2%) cases, individual constructions were used, the average follow-up was 26 months. (from 12 to 50), and in 113 (60.8%) cases, serial implants were used, the average follow-up period was 62 months. (12 to 186). Individual constructions were more often implanted in patients with 3B acetabular defects (p<0.05) and its uncontained defects (p<0.001). The number of cases of aseptic loosening in the group of patients undergoing endoprosthetics using serial implants was greater than in the group of patients with individual constructions for the entire period (p<0.05) and in the early stages of observation (p<0.05).Conclusion. In case of RHA in patients with severe acetabular defects, individual implants, in comparison with serials, demonstrate better survival with an average follow-up of 26 months and due to design features, they can count on great long-term effectiveness. This study needs to be continued to increase follow-up.

scholarly journals Two-Stage Revision Arthroplasty for Periprosthetic Hip Infection: Mean Follow-Up of Ten Years

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Szu-Yuan Chen ◽  
Chi-Chien Hu ◽  
Chun-Chieh Chen ◽  
Yu-Han Chang ◽  
Pang-Hsin Hsieh
Keyword(s):  
Hip Arthroplasty ◽  
Cox Regression ◽  
Joint Infection ◽  
Revision Arthroplasty ◽  
Revision Hip Arthroplasty ◽  
Harris Hip Score ◽  
Two Stage ◽  
Eradication Of Infection ◽  
The Mean

Background. Two-stage revision hip arthroplasty is the gold standard for treatment of patients with chronic periprosthetic joint infection (PJI), but few studies have reported outcomes beyond short-term follow-up.Methods. A total of 155 patients who underwent two-stage revision arthroplasty for chronic PJI in 157 hips were retrospectively enrolled in this study between January 2001 and December 2010. The mean patient age was 57.5 years, the mean prosthetic age was 3.6 years, and the interim interval was 17.8 weeks. These patients were followed up for an average of 9.7 years.Results. At the latest follow-up, 91.7% of the patients were free of infection. The mean Harris hip score improved significantly from 28.3 points before operation to 85.7 points at the latest follow-up. Radiographically, there was aseptic loosening of the stem or acetabular components in 4 patients. In the multivariate survival analysis using a Cox regression model, repeated debridement before final reconstruction, an inadequate interim period, bacteriuria or pyuria, and cirrhosis were found to be the independent risk factors for treatment failure.Conclusion. Our data show that two-stage revision hip arthroplasty provides reliable eradication of infection and durable reconstruction of the joint in patients with PJI caused by a variety of pathogens.

scholarly journals Clinical outcomes and survival rate of cementless modular distal fixation femoral stem for revision hip arthroplasty: A minimum 6-year follow-up

2018 ◽  
Vol 26 (3) ◽  
pp. 230949901881224 ◽  
Author(s):  
Joon Soon Kang ◽  
Yeop Na ◽  
Bong Seong Ko ◽  
Yoon Sang Jeon
Keyword(s):  
Survival Rate ◽  
Hip Arthroplasty ◽  
Periprosthetic Fracture ◽  
Femoral Stem ◽  
Revision Hip Arthroplasty ◽  
Harris Hip Score ◽  
The Mean ◽  
Distal Fixation

Purpose: Revision hip arthroplasty is a very challenging procedure. Use of a modular distal fixation stem is one of the available options for revision arthroplasty in patients with proximal femoral bone deficiency. The purpose of this study was to evaluate mid- to long-term outcomes of cementless modular distal fixation femoral stem implantation in revision hip surgery. Methods: Clinical and radiological findings, complications, and stem survival rate were analyzed for 46 patients (48 hips) who underwent revision hip arthroplasty using a cementless modular distal fixation femoral stem. The mean patient age was 58.8 years (range 31–82 years) and the mean follow-up period was 95 months (72–122 months). The preoperative diagnoses were aseptic loosening (36 hips), infection (4 hips), ceramic fracture (4 hips), and femoral periprosthetic fracture (4 hips). Results: The mean Harris hip score improved from 56.6 preoperatively to 88.2 postoperatively at the last follow-up. All hips showed stable osteointegration and firm fixation. Complications involved four hips (8.3%); there was one case each of periprosthetic fracture, delayed union of osteotomy site, femoral perforation, and infection. One stem re-revision was performed for deep infection of the femoral side. The Kaplan–Meier survival rate was 97.6% at the final follow-up. Conclusion: Revision hip arthroplasty using a cementless modular distal fixation femoral stem showed satisfactory initial firm fixation and mid- to long-term survival rate. Complications can be minimized by careful surgical planning and meticulous procedure.

Femoral Impaction Allografting for Significant Bone Loss in Revision Hip Arthroplasty

2017 ◽  
Vol 27 (3) ◽  
pp. 281-285 ◽  
Author(s):  
Thomas A.J. Goff ◽  
Peter Bobak
Keyword(s):  
Bone Loss ◽  
Femoral Component ◽  
Hip Arthroplasty ◽  
Revision Arthroplasty ◽  
Bone Allograft ◽  
Revision Hip Arthroplasty ◽  
Stem Subsidence ◽  
Impaction Allografting ◽  
Component Revision

Introduction Femoral impaction bone allografting in revision hip arthroplasty facilitates physiological reconstruction with restoration of bone stock, allowing implantation of a standard cemented femoral component. The purpose of this study was to report our experience in femoral component revision arthroplasty with impaction morsellised cancellous bone allograft using custom impactors and a cemented triple-taper polished stem. Methods Retrospective analysis of all cases of femoral component revision hip arthroplasty with impaction bone grafting undertaken by a single surgeon from 2005 to 2011. Outcome measures included radiographic analysis of stem subsidence over time, graft remodelling and incorporation, and clinical progress. Results We reviewed 47 consecutive hips in 44 patients, mean age 62 years (37-88). Femoral impaction with allograft was performed as either single stage (41 cases) or 2-stage (6 cases) procedures. All patients received a cemented C-stem prosthesis. The mean follow-up period was 5.1 (1.3-9.4) years. The median pre-operative bone defect score was 3 (interquartile range [IQR] 2-3) using the Endo-Klinik classification. Radiological evidence of graft incorporation was observed in 89% (281 of 315 zones) with additional remodelling observed in 33% (103 of 315 zones). The median stem subsidence at 1-year follow-up was 1.1 mm (standard deviation [SD] 1.24 mm, range 0-6 mm). The median Oxford Hip Score at the most recent follow-up was 36.5. To date no femoral component has undergone further revision. Conclusions Encouraging results have been obtained with this technique for the treatment of significant bone loss in revision hip arthroplasty, allowing implantation of a standard prosthesis.

Multivariate analysis of risk factors for re-dislocation after revision for dislocation after total hip arthroplasty

2019 ◽  
Vol 30 (1) ◽  
pp. 93-100 ◽  
Author(s):  
Amir Herman ◽  
Bassam A Masri ◽  
Clive P Duncan ◽  
Nelson V Greidanus ◽  
Donald S Garbuz
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Recurrent Dislocation ◽  
Revision Hip Arthroplasty ◽  
Time To Event ◽  
Total Hip ◽  
Risk Of Failure ◽  
Increase Risk ◽  
Hip Arthroplasties

Background:The treatment for recurrent dislocation of a total hip arthroplasty is surgical using varied techniques and technologies to reduce the chances of re-dislocation and re-revision. The goal of this study is to compare operative techniques to reduce re-dislocation and re-revision in revision hip arthroplasty due to recurrent dislocations.Methods:A retrospective study of revision hip arthroplasties done due to recurrent dislocation prior to 01 January 2014. Electronic physician and provincial health records were used to collect patients’ initial and follow-up data. Treatment failure was defined as either aseptic re-revision or re-dislocation without revision. Time to event was considered as the re-revision date or the date of second dislocation when the latter endpoint was used.Results:Of 379 operations, 88 (23.2%) had aseptic repeat revision or recurrent dislocation. Of these: 66 (75.0%) due to dislocation with re-revision; 10 (11.4%) due to dislocation with no re-revision surgery; 5 (5.7%) due to aseptic loosening of components; 3 (3.4%) due to osteolysis; 3 (3.4%) due to pseudotumour; and 1 (1.1%) due to periprosthetic fracture. The following factors increase risk of failure: the use of augmented-liners (lipped, oblique and high-offset liners; HR = 1.68, 95% CI, 1.05–2.69), periprosthetic femur fracture (HR = 2.80, 95% CI, 1.39–8.21) and pelvic discontinuity (HR = 3.69, 95% CI, 1.66–8.21). Femur head sizes 36–40 mm are protective (HR = 0.54, 95% CI, 0.31–0.86). In abductor dysfunction the use of focal constrained liners decreases the risk of failure (HR = 0.13, 95% CI, 0.018–0.973).Conclusions:Larger head sizes and focal constrained liners (abductors dysfunction) should be used and fully constrained liners and augmented-liners should be avoided in a revision hip arthroplasty due to recurrent dislocations.

Results of Cementless Femoral Components Use at Revision Hip Arthroplasty

2012 ◽  
Vol 19 (4) ◽  
pp. 15-21 ◽  
Author(s):  
N. V Zagorodniy ◽  
V. I Nuzhdin ◽  
K. M Bukhtin ◽  
S. V Kagramanov
Keyword(s):  
Bone Tissue ◽  
Hip Arthroplasty ◽  
Group Analysis ◽  
Revision Hip Arthroplasty ◽  
Total Hip ◽  
Detailed Characteristic ◽  
Group 3 ◽  
Group 2 ◽  
Hip Arthroplasties

Results of 98 revision total hip arthroplasties performed using cementless stems during the period from 2000 to 2012 are presented. In 1 st group of patients (36 operations) revision SLR stems were used. In group 2 (34 interventions) and group 3 (28 interventions) Solution stems and Wagner stems were implanted, respectively. Detailed characteristic of implants was given with account to the type of fixation. Follow up was from 3 to 6 years. Excellent and good results were achieved in 21 patients (58.33%)from the 1 st group, 14patients (41.18%) from the 2 nd group and 16 patients (57.14%) from the 3 rd group. Analysis of intraoperative, early (up to 6 months) and late (over 6 months) complications was performed. Recommendations for choice of revision femoral components depending on the degree of bone tissue defect are given.

scholarly journals Minimum 10 years clinical and radiological outcomes of acetabular revisions of total hip arthroplasties with tricalcium phosphate/hydroxyapatite bone graft substitute

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jacek Gagala
Keyword(s):  
Bone Graft ◽  
Revision Arthroplasty ◽  
Bone Defects ◽  
Bone Graft Substitute ◽  
Acetabular Bone ◽  
Total Hip ◽  
Acetabular Bone Defects ◽  
Bone Graft Substitutes ◽  
Hip Arthroplasties

Abstract Background Aseptic loosening is the most frequent indication for revision of total hip arthroplasty. Revision arthroplasty of acetabular component is a challenge for every surgeon because they have to simultaneously deal with the reconstruction of bone defects, adequate implant geometry and stable fixation. Allografts are the most frequently used materials in reconstruction of bone loss during revision surgeries. Because of an increasing number of revision hip arthroplasties and poor availability of allografts, we decided to use bone graft substitutes in acetabular revisions. Methods Between September 2005 and January 2010, 44 revision arthroplasties in 43 patients were performed with the use of bone graft substitutes for acetabular defect reconstruction in revision of total hip arthroplasty. Acetabular bone defects were classified according to Paprosky. Seventeen hips were classified as IIA, 3 hips IIB, 3 hips IIC, 10 hips IIIA and 11 hips IIIB. Acetabular bone defects were reconstructed with tricalcium phosphate/hydroxyapatite bone graft substitute - BoneSave. Clinical and radiological examination was performed after 3 months, 1 year and then annually. Harris hip score was used for clinical evaluation. Survival analysis was performed with Kaplan-Meier method with aseptic loosening as the definition of endpoint. Results The average follow-up period is 12 (range from 10 to 15) years. During the follow-up, three patients died after 24 months because of causes not related to surgery. None of the patients was lost to follow-up. The evaluation of clinical results revealed an increase in pre-operative HHS from average 38.3 (range 25 to 55) points to average 86.3 (range 45 to 95) points at the most recent follow-up. Radiographic evaluation showed the migration of one revision cage 12 months after surgery. Revision arthroplasty performed after 14 months revealed the partial incorporation of bone graft substitute. There were not any cases of loosening of revision acetabular cup at the most recent follow up examination in the remaining 39 patients. Bone graft substitute was not absorbed in all of these patients. The survival after 10 years amounted to 97.56%. Conclusion Bone graft substitute Bone Save may be suitable for acetabular revision surgery, however preoperative bone defect is critical for success and determining of a surgical technique, so this is multifactorial in this challenge surgery.

Sign in / Sign up

Export Citation Format

Share Document