A 2- to 16-Year Clinical Follow-Up of Revision Total Hip Arthroplasty Using a New Acetabular Implant Combined With Impacted Bone Allografts and a Cemented Cup

Stigbrand, Hampus; Gustafsson, Oscar; Ullmark, Gösta

doi:10.1016/j.arth.2017.10.006

Cited by 27 publications

(26 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The evidence on which the decision to use a prosthesis to revise a failed PFNA was based was vague and controversial [19]. In addition, the operating specifications for reducing or avoiding mechanical complications were rarely mentioned in the previous literature [7,20].…”

Section: Discussionmentioning

confidence: 99%

Conversion from a failed proximal femoral nail anti-rotation to a cemented or uncemented total hip arthroplasty device: a retrospective review of 198 hips with previous intertrochanteric femur fractures

Han

Chen

et al. 2020

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background At present, it is unclear which device (uncemented or cemented total hip arthroplasty [UTA or CTA, respectively]) is more suitable for the conversion of a failed proximal femoral nail anti-rotation (PFNA). The aim of this review was to assess the outcomes of failed PFNAs converted to a UTA or CTA device in elderly individuals with intertrochanteric femoral fractures (IFFs). Methods Two hundred fifty-eight elderly individuals (258 hips) with IFFs who underwent a conversion to a UTA or CTA device following failed PFNAs during 2007–2017 were retrospectively identified from the China Southern Medical Centre (CSMC) database. The primary endpoint was the Harris Hip Score (HHS); secondary endpoint was the key orthopaedic complication rate. Results The median follow-up was 65 months (60–69 months). Significant distinctions were observed (87.26 ± 16.62 for UTA vs. 89.32 ± 16.08 for CTA, p = 0.021; 86.61 ± 12.24 for symptomatic UTA vs. 88.68 ± 13.30 for symptomatic CTA, p = 0.026). A significant difference in the overall key orthopaedic complication rate was detected (40.8% [40/98] vs. 19.0% [19/100], p = 0.001). Apparent distinctions were detected in terms of the rate of revision, loosening, and periprosthetic fracture (11.2% for UTA vs 3.0% for CTA, p = 0.025; 13.2% for UTA vs 5.0% for CTA, p = 0.043; 10.2% for UTA vs 3.0% for CTA, p = 0.041, respectively). Conclusion For elderly individuals with IFFs who suffered a failed PFNA, CTA devices may have a noteworthy advantage in regard to the revision rate and the rate of key orthopaedic complications compared with UTA devices, and CTA revision should be performed as soon as possible, regardless of whether these individuals have symptoms.

show abstract

Section: Discussionmentioning

confidence: 99%

Conversion from a failed proximal femoral nail anti-rotation to a cemented or uncemented total hip arthroplasty device: a retrospective review of 198 hips with previous intertrochanteric femur fractures

Han

Chen

et al. 2020

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…It is widely accepted in the orthopedic community that allografts represent a suitable option to address small to large acetabular or femoral bone defects, which represent a common problem in revision procedures (especially revision THA). This notion is primarily based on clinical and radiological evidence with good to excellent outcomes for structural and chip allografts in both the acetabulum 9,19,[30][31][32][33] and the femur 14,19,[34][35][36] . On a histological level, previous studies in the acetabulum were limited to small n-numbers and indicated remained integrity of structural allografts with minimal remodeling 37 .…”

Section: Discussionmentioning

confidence: 99%

A novel, multi-level approach to assess allograft incorporation in revision total hip arthroplasty

Rolvien

Friesecke²,

Butscheidt

et al. 2020

Sci Rep

View full text Add to dashboard Cite

The successful use of allografts in reconstructive orthopedic surgery, including revision total hip arthroplasty (THA), has been outlined repeatedly. Nonetheless, as previous studies were primarily based on clinical follow-ups, we aimed to create an algorithm that accurately determines the extent of allograft incorporation in the acetabulum and femur using a suite of high-resolution imaging techniques. This study is based on a large patient database including > 4,500 patient data with previous revision THA and simultaneous use of allografts. While the database was continuously matched with the deceased individuals at the local forensic medicine department, complete hips were retrieved in case of a positive match. A positive match was achieved for n = 46 hips at a mean follow-up of 11.8 ± 5.1 years. Comprehensive imaging included contact radiography, high-resolution computed tomography (HR-pQCT), undecalcified histology of ground sections and quantitative backscattered electron imaging (qBEI). We here define a histomorphometric toolkit of parameters to precisely characterize the incorporation of structural (bulk) and morselized (chip) allografts in the acetabulum (n = 38) and femur (n = 8), including the defect area and interface length, microstructural and cellular bone turnover parameters as well as overlap and fibrosis thickness. This collection of samples, through its unique study design and precise definition of incorporation parameters, will provide the scientific community with a valuable source for further in-depth investigation of allograft incorporation and, beyond that, the regenerative potential of this osteoconductive scaffold.

show abstract

“…However, for younger groups, the choice of prosthesis is still controversial [13]. Recent studies [22,19] have shown that CTA devices have noteworthy advantages in terms of functional outcomes and orthopaedic complications for failed PFNAs in young patients compared to UTA devices.…”

Section: Discussionmentioning

confidence: 99%

Conversion from a failed proximal femoral nail anti-rotation to a cemented or uncemented total hip arthroplasty device: A retrospective review of 198 hips with previous intertrochanteric femur fractures

Han

Chen

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: At present, it is unclear which device ( uncemented or cemented total hip arthroplasty [UTA or CTA, respectively]) is more suitable for the conversion of a failed proximal femoral nail anti-rotation (PFNA). The aim of this review was to assess the outcomes of failed PFNAs converted to a UTA or CTA device in elderly individuals with intertrochanteric femoral fractures (IFFs) . Methods: Two hundred fifty-eight elderly individuals (258 hips) with IFFs who underwent a conversion to a UTA or CTA device following failed PFNAs during 2007-2017 were retrospectively identified from the China Southern Medical Centre (CSMC) database. The primary endpoint was the Harris Hip Score (HHS); secondary endpoint was the key orthopaedic complication rate. Results: The median follow-up was 65 months (60-69 months). Significant distinctions were observed (87.26±16.62 for UTA vs. 89.32±16.08 for CTA, p=0.021; 86.61±12.24 for symptomatic UTA vs. 88.68±13.30 for symptomatic CTA, p=0.026). A significant difference in the overall key orthopaedic complication rate was detected (40.8% [40/98] vs. 19.0% [19/100], p =0.001). Apparent distinctions were detected in terms of the rate of revision, loosening, and periprosthetic fracture (11.2% for UTA vs 3.0% for CTA, p = 0.025; 13.2% for UTA vs 5.0% for CTA, p = 0.043; 10.2% for UTA vs 3.0% for CTA, p = 0.041, respectively). Conclusion: For elderly individuals with IFFs who suffered a failed PFNA , CTA devices may have a noteworthy advantage in regard to functional scores and the rate of key orthopaedic complications compared with UTA devices, and CTA revision should be performed as soon as possible, regardless of whether these individuals have symptoms.

show abstract

A 2- to 16-Year Clinical Follow-Up of Revision Total Hip Arthroplasty Using a New Acetabular Implant Combined With Impacted Bone Allografts and a Cemented Cup

Abstract: IBG combined with the compressing shell results in excellent results for this challenging condition.

Cited by 27 publications

References 57 publications

Conversion from a failed proximal femoral nail anti-rotation to a cemented or uncemented total hip arthroplasty device: a retrospective review of 198 hips with previous intertrochanteric femur fractures

Conversion from a failed proximal femoral nail anti-rotation to a cemented or uncemented total hip arthroplasty device: a retrospective review of 198 hips with previous intertrochanteric femur fractures

A novel, multi-level approach to assess allograft incorporation in revision total hip arthroplasty

Conversion from a failed proximal femoral nail anti-rotation to a cemented or uncemented total hip arthroplasty device: A retrospective review of 198 hips with previous intertrochanteric femur fractures

Contact Info

Product

Resources

About