Acetabular revision using a total acetabular allograft

Malhotra, Rajesh; Kumar, Vijay

doi:10.4103/0019-5413.50860

Cited by 3 publications

(1 citation statement)

References 8 publications

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“…The deficit of bone stock can lead to serious technical difficulties for the implantation of the acetabulum in the condition of compromised columns, superior and medial walls of the acetabulum. Besides, as acetabular osteolysis progresses, the remaining bone stock cannot always provide correct installation of press-fit cups and screws (for primary mechanical stability of the component) and create favorable conditions for osteointegration, which correlates with the dates of the normal functioning of the endoprosthesis [5][6][7][8][9][10]. Presently, there are several surgical technics of acetabular revisions in patients with massive osteolysis for the restoration of acetabular bone stock.…”

Section: Introductionmentioning

confidence: 99%

The Use of Structure Transplants With Revision Endoprosthetics in Conditions of Significant Acetabular Osteolysis

Karpukhin¹,

Тихилов²,

Tsybin³

2018

MPSES

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To study long-term results of acetabular revisions with use of structural bone allografts in severe acetabular bone loss (2C, 3A and 3B by W. Paprosky classification). Materials and Methods One hundred eighty-three acetabular revisions with the use of bone allografts were performed; of these, structural bone allografts were used in 21 cases. In 7 cases, total revisions were performed; in 14 cases, isolated acetabular revisions were performed. In 20 cases (95%), the reason for revision surgery was the aseptic failure of the acetabular or both components, in one case it was the sequel after deep infection. In three cases (14%), before implantation of the acetabulum, bone grafting was performed with structural allografts-the femoral headswith screw fixation. In 18 cases (86%), structural allografts were tightly impacted in a previously prepared bone stock followed by the installation of the acetabular component. Results. This is an analysis of the long-term results of the use of structural allografts in 16 acetabular revisions with massive bone defects. The mean term follow up in the group was 75.35±31.1 months (7-185 months). Of 16 cases of acetabular revision in the group, in three cases (18.75%) trabecular remodelling of allografts was noted, in three cases (18.75%) there occurred trabecular incorporation, and in ten cases there were lack of changes in comparison with postoperative X-rays. In five cases (31.25%), stage I resorption of transplants was recorded according to Sporer (lack of resorption); in six cases (37.5%) stage II resorption (less than 25%), in three cases (18.75%) stage III (25-50%), and in two cases stage IV resorption was noted (over 50% of transplant). Type I stability of Burch-Schneider cage (according to the Gill evaluation system) was revealed in three cases-lack of osteolysis around construction and screws. Mean change of the rotation centre was 0.23 mm; mean change of the inclination angle was 0.1 mm. Type II stability was found in three cases-there was an increase of the osteolysis line upwards and medially. Mean change of the rotation centre was 9.6 mm; mean change of the inclination angel was 10.9. Type III stability was not noted. Evaluation of the condition of press-fit fixation components (according to Moore) showed that in five cases there was lack of component migration, mean change of the rotation centre was 3.75 mm, and mean change of the inclination angle was 1.4. In five cases, there was component migration, mean change of the rotation centre was 5.44 mm, and mean change of the inclination angle was 14.06. In two cases out of 10, there was mechanical damage of the components (screw fractures) Conclusions. The use of structural allografts for filling of massive acetabular defects in acetabular revision is an effective method for the restoration of the bone stock, which allows to restore the centre of rotation and to install the acetabular component in its correct position.

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Section: Introductionmentioning

confidence: 99%

The Use of Structure Transplants With Revision Endoprosthetics in Conditions of Significant Acetabular Osteolysis

Karpukhin¹,

Тихилов²,

Tsybin³

2018

MPSES

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Computerized Tools: Allograft Selection

Bousleiman

2016

Computer-Assisted Musculoskeletal Surgery

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Comparative Evaluation of Pelvic Allograft Selection Methods

2013

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This paper presents a firsthand comparative evaluation of three different existing methods for selecting a suitable allograft from a bone storage bank. The three examined methods are manual selection, automatic volume-based registration, and automatic surface-based registration. Although the methods were originally published for different bones, they were adapted to be systematically applied on the same data set of hemi-pelvises. A thorough experiment was designed and applied in order to highlight the advantages and disadvantages of each method. The methods were applied on the whole pelvis and on smaller fragments, thus producing a realistic set of clinical scenarios. Clinically relevant criteria are used for the assessment such as surface distances and the quality of the junctions between the donor and the receptor. The obtained results showed that both automatic methods outperform the manual counterpart. Additional advantages of the surface-based method are in the lower computational time requirements and the greater contact surfaces where the donor meets the recipient.

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Acetabular revision using a total acetabular allograft

Cited by 3 publications

References 8 publications

The Use of Structure Transplants With Revision Endoprosthetics in Conditions of Significant Acetabular Osteolysis

The Use of Structure Transplants With Revision Endoprosthetics in Conditions of Significant Acetabular Osteolysis

Computerized Tools: Allograft Selection

Comparative Evaluation of Pelvic Allograft Selection Methods

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