scholarly journals 10-year results following impaction bone grafting of major bone defects in 29 rotational and hinged knee revision arthroplasties

2013 ◽  
Vol 84 (4) ◽  
pp. 387-391 ◽  
Author(s):  
Verena Hilgen ◽  
Mustafa Citak ◽  
Eik Vettorazzi ◽  
Carl Haasper ◽  
Kimberly Day ◽  
...  
Keyword(s):  
Bone Grafting ◽  
Bone Defects ◽  
Impaction Bone Grafting ◽  
Revision Arthroplasties ◽  
Knee Revision

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.

scholarly journals Mid-term results of impaction bone grafting in tibial bone defects in complex primary knee arthroplasty for severe varus deformity

SICOT-J ◽  
2019 ◽  
Vol 5 ◽  
pp. 2
Author(s):  
Yashwant Singh Tanwar ◽  
Yatinder Kharbanda ◽  
Harsh Bhargava ◽  
Kulbhushan Attri ◽  
Anoop Bandil
Keyword(s):  
Knee Arthroplasty ◽  
Bone Grafting ◽  
Primary Total Knee Arthroplasty ◽  
Varus Deformity ◽  
Womac Score ◽  
Bone Defects ◽  
Impaction Bone Grafting ◽  
Tibial Condyle ◽  
Primary Knee Arthroplasty ◽  
The Many

Introduction: Bone defects are a challenging problem encountered occasionally during primary knee arthroplasty. These defects should be meticulously addressed so as to avoid malalignment and premature loosening and failure. Out of the many options available to deal with these defects, impaction bone grafting provides a more biological solution, which is especially important in case of primary knees. Materials and methods: A retrospective analysis was done and patients with severe varus deformity of more than 20 degrees who had undergone primary knee arthroplasty with impaction bone grafting of the tibial condyle defect were followed up. Results: Between 2008 and 2014, out of the 1124 patients who underwent primary total knee arthroplasty, only 26 knees in 23 patients met the inclusion criteria. The amount of varus deformity ranged from 20 to 35 degrees. Follow-up ranged from 3 to 8 years with an average of 6 years. The average pre-operative Knee Society Score (KSS) and Western Ontario McMaster Universities (WOMAC) score were 24.2 and 78, respectively. There were significant improvements in the post-op scores, with the average KSS being 90.2 and the WOMAC being 38. Conclusion: Impaction bone grafting provides an invaluable option to the orthopedic surgeon for managing bone defects, especially in case of primary knee arthroplasty as it reconstitutes the bone stock.

From bench to clinic and back: skeletal stem cells and impaction bone grafting for regeneration of bone defects

2012 ◽  
Vol 8 (10) ◽  
pp. 779-786 ◽  
Author(s):  
A. Aarvold ◽  
J. O. Smith ◽  
E. R. Tayton ◽  
A. M. H. Jones ◽  
J. I. Dawson ◽  
...  
Keyword(s):  
Stem Cells ◽  
Bone Grafting ◽  
Bone Defects ◽  
Impaction Bone Grafting ◽  
Regeneration Of Bone

Acetabular impaction grafting with mesh for acetabular bone defects: a systematic review

2020 ◽  
pp. 112070002097185
Author(s):  
Michael-Alexander Malahias ◽  
Fabio Mancino ◽  
Alex Gu ◽  
Marco Adriani ◽  
Ivan De Martino ◽  
...  
Keyword(s):  
Bone Loss ◽  
Bone Grafting ◽  
Survival Rates ◽  
Bone Defects ◽  
Reoperation Rate ◽  
Impaction Bone Grafting ◽  
Acetabular Bone ◽  
Acetabular Bone Loss ◽  
Cochrane Database ◽  
Acetabular Bone Defects

Introduction: In conjunction with impaction bone grafting (IBG), metal meshes have been proposed to minimise defects of the medial and superolateral walls in order to convert combined complex uncontained segmental defects into contained cavitary defects to facilitate IBG. Methods: The US National Library of Medicine (PubMed/MEDLINE), EMBASE, and the Cochrane Database of Systematic Reviews were queried for publications from January 1980 to March 2019 utilising keywords pertinent to total hip arthroplasty (THA), acetabular impaction bone grafting, clinical or functional outcomes, revision THA, or postoperative complications. Results: 7 articles were found to be suitable for inclusion in the present study. The mean modified Coleman methodology score for methodological deficiencies of the studies was 45.3 (range 38–59). Severe acetabular bone loss was present in 56% of cases having moderate bone loss in 18%, and mild in 26%. The all-cause reoperation rate was 7.4%, while the all-cause revision rate of the acetabular component was 6.2%. Conclusions: IBG with mesh is effective for selected patients with acetabular bone defects. Most patients with moderate bone loss as well as selected patients with large superolateral defects can be successfully treated with IBG combined with mesh. There is limited data to show that IBG with mesh might be associated with decreased survival rates in patients with severe lateral defects (Paprosky IIIA) combined with ischial or medial wall osteolysis who require combined medial and lateral meshes. In addition, patients with severe superomedial migration of the cup (Paprosky IIIB) should not be treated with IBG and mesh.

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