Clinical evaluation and surgical options in acetabular reconstruction: A literature review

Ahmad, Asim; Schwarzkopf, Ran

doi:10.1016/j.jor.2015.10.011

Cited by 26 publications

(17 citation statements)

References 42 publications

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“…This is a technically more demanding procedure, revision implants are often necessary, and can range from changing a worn-out polyethylene liner in a not yet unstable hip to a two-stage revision for a difficult to treat infection with substantial bone loss. Results of rTHA’s are less favourable than those seen in pTHA’s due to the fact that complications are more common, survival of implants is shorter, and patients report lower on outcome measures (PROMs) [ 2 – 4 ].…”

Section: Introductionmentioning

confidence: 99%

RETRACTED ARTICLE: The majority of conversion total hip arthroplasties can be considered a primary replacement: a matched cohort study

et al. 2020

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Background and study aims The success of conversion total hip arthroplasty (THA) among primary THA and revision THA remains unclear. We hypothesized that most conversion THA’s can be performed using primary implants and will have an uncomplicated post-operative course. Materials and methods Thirty-six patients (23 females, mean age 68,0y) who underwent conversion THA for failed interventions for proximal femur fractures in the period 2008–2018 were matched sequentially against patients of the same sex and age who underwent primary THA or revision THA. Data were collected on implants used, major complications, and mortality. PROMs used included the Western Ontario and McMaster Osteoarthritis Index, Harris Hip Score, Visual Analogue Scale and the EQ-5D Health Questionnaire. Results Seventy-two percent of patients who underwent conversion THA were treated with primary implants and never suffered from a major complication. PROMs were excellent for this group of patients. The distinction primary/conversion/revision THA could not explain differences in outcomes; however, the necessity of using revision implants and the development of major complications could. Conclusions The majority of conversion total hip arthroplasties can be considered a primary replacement. Predicting outcomes for THA should focus on patient frailty and technical difficulties dealing with infection, stability and loss of bone stock and should discard the conversion versus revision terminology.

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Section: Introductionmentioning

confidence: 99%

RETRACTED ARTICLE: The majority of conversion total hip arthroplasties can be considered a primary replacement: a matched cohort study

et al. 2020

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“…More recently, trabecular tantalum metal augments have become an attractive alternative to structural allografts. Despite the advantages of a porous structure with a high shear strength profile which reduces micromotion between native bone and prosthesis, and behaviour like cancellous bone allowing bone ingrowth, vulnerability and the cost prevents usage in common (26)(27)(28).…”

Section: Discussionmentioning

confidence: 99%

Determination of Structural Femoral Head Allograft Viability and Integrity with a Novel Diagnostic Tool: SPECT/CT. A Preliminary Study

Kılıçarslan¹,

Yalçın²,

Biçici

et al. 2017

HIP International

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Objective To evaluate the viability and integrity of fresh frozen bulk femoral head allografts obtained from the institutional bone bank that were used to reconstruct severe acetabular defects and to validate the SPECT/CT method which gives both anatomical and functional data for this purpose. Methods We retrospectively reviewed 9 patients (6 female, 3 male; mean age 63.6 years). Preoperative and postoperative leg lengths, existence of the Trendelenburg sign, range of motion of the hip, visual analogue score (VAS), Harris Hip Score (HHS) and any complication were assesed at each follow-up. Radiographically, position of the cup, signs of loosening or migration, and union of the graft were all determined. At the latest follow-up, patients were evaluated with hybrid SPECT/CT. Results The average duration of follow-up was 38.1 months (24-50 months). The overall mean HHS and VAS scores were significantly improved (p<0.05). When hybrid SPECT/CT results were evaluated, the vascular phase of scintigraphy showed hyperaemia of the graft and the bone phase of scintigraphy showed normal or increased radiotracer uptake in the graft site in 7 patients. SPECT/CT images were used to determine the exact localisation of osteoblastic activity. 1 patient with minor resorption of the graft without clinical symptoms revealed mild osteoblastic activity. The patient who had no activity in the graft site was rerevised because of infection. Conclusions Institutional bank allografts are still excellent options for treating large acetabular defects in revision total hip arthroplasty where trabecular metals are not available or in common use. The Hybrid SPECT/CT method is a reliable, noninvasive method for evaluating both the integrity and viability of a bulk graft in 3-D.

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“…по данным a.q. ahmad и R. Schwarzkopf, типичная стоимость cTac, включая гемисферическую часть, винты и вкладыш, сопоставима со стоимостью системы сup-сage и нескольких аугментов, используемых для ревизии в случаях наличия сегментарных дефектов или разобщения костей таза [24]. неудобства, связанные с длительной подготовкой при использовании индивидуальных конструкций, компенсируются улучшением результатов лечения пациентов по сравнению с применением стандартных ревизионных компонентов [6].…”

Section: результатыunclassified

Custom Triflange Acetabular Components in Revision Hip Replacement (Experience Review)

Корыткин

Zakharova

Новикова

et al. 2017

Traumatology and Orthopedics of Russia

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реферат значительные дефекты вертлужной впадины, особенно сопровождающиеся нарушением целостности тазового кольца, являются серьезной проблемой ревизионного эндопротезирования тазобедренного сустава и создают дополнительные сложности для фиксации ацетабулярного компонента эндопротеза. одним из перспективных вариантов решения описанной проблемы является использование индивидуальных трехфланцевых вертлужных компонентов (cTac-custom Triflange acetabular component), проектируемых на основе предоперационной компьютерной томографии с учетом особенностей костных дефектов пациента. Цель исследования-оценить эффективность использования cTac при ревизионном эндопротезировании тазобедренного сустава. Материал и методы. проанализированы результаты лечения 12 пациентов, перенесших ревизионное эндопротезирование с применением аддитивных технологий компьютерного моделирования и 3d-печати cTac. Время наблюдения пациентов после эндопротезирования составило в среднем 7±3 мес. (от 1 до 10 мес.). у 7 пациентов из 12 были выявлены дефекты вертлужной впадины типа 3B по W.g. paprosky, у 4типа 3а и у одного-2с. Результаты. у 2 пациентов из 12 произошли вывихи эндопротеза, что потребовало проведения повторных оперативных вмешательств на тазобедренном суставе, одному из них-открытое вправление вывиха с санацией раны, другому-замена артикулирующей пары ацетабулярного компонента эндопротеза. суммы баллов по шкале Харриса и визуальной аналоговой шкале боли до лечения составили 28±7 и 7±1, соответственно, после эндопротезирования-76±9 и 3±1, соответственно. Выводы. применение аддитивных технологий при ревизионном эндопротезировании тазобедренного сустава у пациентов с обширными костными дефектами вертлужной впадины и таза позволяет провести точное предоперационное планирование, восстановить центр ротации сустава, восполнить дефицит костной ткани, надежно фиксировать индивидуальный трехфланцевый вертлужный компонент эндопротеза, что значительно улучшает результаты лечения и удовлетворенность пациентов операцией. Ключевые слова: ревизионное эндопротезирование тазобедренного сустава, дефекты вертлужной впадины, индивидуальный трехфланцевый вертлужный компонент, 3d-печать в медицине.

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Clinical evaluation and surgical options in acetabular reconstruction: A literature review

Cited by 26 publications

References 42 publications

RETRACTED ARTICLE: The majority of conversion total hip arthroplasties can be considered a primary replacement: a matched cohort study

RETRACTED ARTICLE: The majority of conversion total hip arthroplasties can be considered a primary replacement: a matched cohort study

Determination of Structural Femoral Head Allograft Viability and Integrity with a Novel Diagnostic Tool: SPECT/CT. A Preliminary Study

Custom Triflange Acetabular Components in Revision Hip Replacement (Experience Review)

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