Acetabular Reconstruction With Bone Impaction Grafting and a Cemented Cup

Schreurs, B.W.; Slooff, T. J. J. H.; Gardeniers, J.W.M.; Buma, P.

doi:10.1097/00003086-200112000-00023

Cited by 143 publications

(93 citation statements)

References 43 publications

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“…Slooff et al in 1979 were the first to use impaction bone grafting in hip revision operations. They reported favourable results at short, intermediate, and long term follow-up [15,17,18,21]. They also reported satisfactory results in a group of young patients who underwent primary and revision operations with acetabular bone loss [16,19].…”

Section: Introductionmentioning

confidence: 99%

Acetabular revision surgery with impacted bone allografts and cemented cups in patients younger than 55 years

Comba

Buttaro

Pusso

et al. 2008

International Orthopaedics (SICOT)

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This article summarises a clinical and radiographical analysis of 30 acetabular revisions in patients younger than 55 years old, performed with impaction bone grafting and cemented cups. Preoperative Merle D'Aubigne and Postel functional score was an average 7 points. At a mean follow-up of 86.5 months (range 34-228) functional score averaged 16.3 points. Radiolucent lines with no clinical impact were observed in 7% of DeLee and Charnley acetabular zones evaluated. Massive radiological migration, consistent with clinical failure, was observed in two cups. Three patients underwent re-revision surgery (10%): two due to infection and one due to mechanical failure. Reconstruction survival rate was 89% (CI 95% 71.9-96.4) overall, and 96% (CI 95% 82.6-99.3) ruling out cases of infection. Impacted bone allograft constitutes one of the reconstructive techniques of choice in acetabular revision surgery of young patients. Restoration of bone stock is essential in this group of patients due to the possibility of future revisions.

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Section: Introductionmentioning

confidence: 99%

Acetabular revision surgery with impacted bone allografts and cemented cups in patients younger than 55 years

Comba

Buttaro

Pusso

et al. 2008

International Orthopaedics (SICOT)

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“…At 3 months, this score was 15.2 (12)(13)(14)(15)(16)(17)(18). At 1 year, it was 16.2 (15)(16)(17)(18), and at 5 years it was 17.2 (16)(17)(18). The pre-operative acetabular radiological defects were classified according to the AAOS classification as type I (n=5), type II (n=5) and type III (n=7).…”

Section: Resultsmentioning

confidence: 99%

Acetabular revision with freeze-dried irradiated and chemically treated allograft: a minimum 5-year follow-up of 17 cases

Vargas

Caton²

2007

International Orthopaedics (SICO

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“…One study using radiographs to assess healing of bone graft and progression of lesions noted almost 100% incorporation of bone graft material with a major portion of the lesions no longer visible on radiographs [21], and greater than 90% survival at long term followup [32]. In the revised acetabular group, 47% graft fill was surprising since this procedure allows aggressive curetting and reaming of the lesion and complete visualization and probing of the acetabulum.…”

Section: Discussionmentioning

confidence: 99%

The Fate of Grafting Acetabular Defects During Revision Total Hip Arthroplasty

Mall

Nunley

Smith

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background Acetabular defects are frequently grafted during revision THA. Previous studies using plain radiographs report high rates of graft incorporation. However, given plain radiographs underestimate osteolysis, it is unclear whether plain radiographs adequately reflect graft fill or incorporation. Questions/purposes We determined if (1) graft fill; or (2) incorporation (measured as graft-bone contact) differed with complete revision and grafting compared to liner exchange and grafting; (3) defect fill and incorporation could be assessed on plain radiographs; and (4) the cost of bone grafting differed with these two procedures. Methods We identified 40 patients who underwent revision THA for aseptic loosening or polyethylene wear and osteolysis, either with retention of a well-fixed cup or complete acetabular revision in which bone graft was used. Lesion size, percent fill, and graft healing was quantified from CT scans. A limited cost analysis was performed using the current hospital costs for implants, bone grafts, and bone graft substitutes. The minimum followup was 1 year (mean, 4.8 years; range, 1-11 years). Results The average defect fill was 30% (range, 0%-81%). The average percent of healing to host bone was 24% (range, 0-66%). Complete revisions had a higher percent defect fill compared to head/liner changes (47% versus 17%) as well as a higher degree of graft healing to host bone compared to head/liner changes (36% versus 14%). High resolution CT demonstrated lower percentages of defect fill and graft healing than previous reports based on plain radiographs. Bone grafting costs exceeded implant costs in the head/liner exchange group; however, the overall cost was higher in the complete revision group. Conclusions Higher degrees of defect fill and healing were seen with complete revisions compared to head/liner exchanges. Compared to CT scans, plain radiograph assessment tended to overestimate defect fill and healing. Level of Evidence Level III, therapeutic study. See the guidelines online for a complete description of level of evidence.

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Acetabular Reconstruction With Bone Impaction Grafting and a Cemented Cup

Cited by 143 publications

References 43 publications

Acetabular revision surgery with impacted bone allografts and cemented cups in patients younger than 55 years

Acetabular revision surgery with impacted bone allografts and cemented cups in patients younger than 55 years

Acetabular revision with freeze-dried irradiated and chemically treated allograft: a minimum 5-year follow-up of 17 cases

The Fate of Grafting Acetabular Defects During Revision Total Hip Arthroplasty

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