scholarly journals Acetabular revision using ReadiGraft® BLX Putty and cortical/cancellous bone chips

2021 ◽  
Vol 2 (2) ◽  
pp. 037-045
Author(s):  
Giampietro Bertasi ◽  
Mariana Peroni
Keyword(s):  
Total Hip Arthroplasty ◽  
Bone Loss ◽  
Successful Outcome ◽  
Defect Classification ◽  
Acetabular Defect ◽  
Revision Total Hip Arthroplasty ◽  
Acetabular Bone ◽  
Pelvic Discontinuity ◽  
Acetabular Bone Loss ◽  
Operative Assessment

Acetabular bone loss presents a challenge to the revision total hip arthroplasty surgeon. It is described a technique of stressing the acetabular bone intra-operatively to access for pelvic discontinuity and the use of allograft to fill the bone gap. Three radiographic criteria are assessed on the AP radiograph for pre-operative classification according to the Paprosky system. This paper describes the pre-operative assessment, the acetabular defect classification and the surgery to achieve a successful outcome.

Management of Acetabular Bone Loss in Revision Total Hip Arthroplasty

2011 ◽  
Vol 93 (19) ◽  
pp. 1842-1852 ◽  
Author(s):  
Gregory K Deirmengian ◽  
Benjamin Zmistowski ◽  
Joseph T OʼNeil ◽  
William J Hozack
Keyword(s):  
Total Hip Arthroplasty ◽  
Bone Loss ◽  
Hip Arthroplasty ◽  
Revision Total Hip Arthroplasty ◽  
Acetabular Bone ◽  
Total Hip ◽  
Acetabular Bone Loss

Acetabular Bone Loss in Revision Total Hip Arthroplasty: Evaluation and Management

2013 ◽  
Vol 21 (3) ◽  
pp. 128-139 ◽  
Author(s):  
Neil P. Sheth ◽  
Charles L. Nelson ◽  
Bryan D. Springer ◽  
Thomas K. Fehring ◽  
Wayne G. Paprosky
Keyword(s):  
Total Hip Arthroplasty ◽  
Bone Loss ◽  
Hip Arthroplasty ◽  
Revision Total Hip Arthroplasty ◽  
Acetabular Bone ◽  
Total Hip ◽  
Acetabular Bone Loss

Cup-cage reconstruction for severe acetabular bone loss and pelvic discontinuity

2018 ◽  
Vol 100-B (11) ◽  
pp. 1442-1448 ◽  
Author(s):  
C. Hipfl ◽  
V. Janz ◽  
J. Löchel ◽  
C. Perka ◽  
G. I. Wassilew
Keyword(s):  
Bone Loss ◽  
Revision Surgery ◽  
Hip Dislocation ◽  
Harris Hip Score ◽  
Postoperative Function ◽  
Acetabular Bone ◽  
Pelvic Discontinuity ◽  
Acetabular Bone Loss ◽  
The Mean

AimsSevere acetabular bone loss and pelvic discontinuity (PD) present particular challenges in revision total hip arthroplasty. To deal with such complex situations, cup-cage reconstruction has emerged as an option for treating this situation. We aimed to examine our success in using this technique for these anatomical problems.Patients and MethodsWe undertook a retrospective, single-centre series of 35 hips in 34 patients (seven male, 27 female) treated with a cup-cage construct using a trabecular metal shell in conjunction with a titanium cage, for severe acetabular bone loss between 2011 and 2015. The mean age at the time of surgery was 70 years (42 to 85) and all patients had an acetabular defect graded as Paprosky Type 2C through to 3B, with 24 hips (69%) having PD. The mean follow-up was 47 months (25 to 84).ResultsThe cumulative five-year survivorship of the implant with revision for any cause was 89% (95% confidence interval (CI) 72 to 96) with eight hips at risk. No revision was required for aseptic loosening; however, one patient with one hip (3%) required removal of the ischial flange of the cage due to sciatic nerve irritation. Two patients (6%; two hips) suffered from hip dislocation, whereas one patient (one hip) required revision surgery with cement fixation of a dual-mobility acetababular component into a well-fixed cup-cage construct. Two patients (6%; two hips) developed periprosthetic infection. One patient was successfully controlled with a two-stage revision surgery, while the other patient underwent excision arthroplasty due to severe medical comorbidities. For the whole series, the Harris Hip Score significantly improved from a mean of 30 (15 to 51) preoperatively to 71 (40 to 89) at the latest follow-up (p < 0.001).ConclusionOur findings suggest that cup-cage reconstruction is a viable option for major segmental bone defects involving the posterior column and PD. It allows adequate restoration of the acetabulum centre with generally good stability and satisfactory postoperative function. Instability and infection remain drawbacks in these challenging revision cases. Cite this article: Bone Joint J 2018;100-B:1442–48.

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