Cortical Strut Allografts in the Reconstruction of the Femur in Revision Total Hip Arthroplasty

Emerson, Roger H.; Malinin, Theodore I.; CUELLAR, ALBERTO D.; Head, William C.; Peters, Paul C.

doi:10.1097/00003086-199212000-00007

Cited by 111 publications

(71 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Clinical studies analysing revision THAs showed no distinct differences of mechanical implant failure with strut graft application for hip stems as primary support [3,6,9] or exclusively as bone augmentation of the femur [7,8,10]. Based on these studies it is exceedingly difficult to compare the reported The resulting interface slipping rm 1 to rm 4 (μm) refers to a physiological axial hip moment during walking [22] results due to inconsistent defect classifications and varying degrees of bone loss.…”

Section: Discussionmentioning

confidence: 99%

“…In order to manage these defects, strut allografts are frequently used [2][3][4][5][6][7][8][9][10]. They are individually sized beams of non-vital bone attached to the deficient femur via tension or cable wires.…”

Section: Introductionmentioning

confidence: 99%

“…Incorporation and remodeling of these allografts to the host bone has been shown to be successful in 80-100 % of cases in numerous studies [2][3][4][5][6][7][8][9][10][11]. Some authors solely use strut grafts to rebuild the proximal femur [7,8,10], whereas other orthopaedic surgeons also rely on these grafts for a support of the stem to achieve better stability [3,6,9]. Although primary stability is the basic requirement for osteointegration, and subsequent good longterm stability of the implant [12][13][14], there is no evidence that strut grafts have an effect on primary fixation of revision stems.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Strut grafts in revision hip arthroplasty faced with femoral bone defects: an experimental analysis

Kinkel

Thomsen

Nadorf

et al. 2014

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

Purpose In total hip arthroplasty fixation of revision stems can be demanding due to femoral bone loss. Strut grafts are often used for bone augmentation and stabilization of the newly inserted prosthesis. The aim of this study was to assess the effect of strut grafts on primary stability under various stem fixation conditions. Methods Two different revision stems (cylindrical and conical shape) were implanted into synthetic femora. Following a semicircular transfemoral osteotomy, three deficient femoral bearings were simulated (bony lid reattached with cable wires; weakened lid reattached with cable wires; strut grafts placed to the weakened lid with cable wires). Relative micromovements were measured between prostheses and bones due to an axial moment applied to the stems. Results Relative movements correlated to the stem shape. The cylindrical stem showed higher movements increasing significantly with a weakened bony lid and portrayed a slight decrease of movements with strut graft application. No unequivocal influence of the weakened lid could be detected for the conical implant. Strut graft application did not show an additional stabilizing effect. Conclusions The primary stability of the cylindrical fixation concept decreases with impaired fixation conditions of the femur. A clear restabilizing effect with strut grafts could not be proven. A decrease of primary stability due to the impaired bone could not be observed for the conical stem shape. Additionally, strut grafts do not enhance fixation for this stem shape. We conclude that surgeons should not rely on a stabilizing effect of strut grafts in revision hip surgery.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Strut grafts in revision hip arthroplasty faced with femoral bone defects: an experimental analysis

Kinkel

Thomsen

Nadorf

et al. 2014

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

show abstract

“…The histological and mechanical response to onlay strut allografts has been well documented in the canine model [1,9,10]. A zone of highly vascularised mesenchymal tissue forms at the host-graft junction.…”

Section: Discussionmentioning

confidence: 99%

“…In an effort to provide improved screw fixation, cortical strut allografts can be used as a way of anchoring the screw to the opposite cortex, thus "sandwiching" the host shaft. The allograft struts provide stability to the fracture site, and they can incorporate [4] and ultimately increase the femoral or humeral bone stock [1,7,9,13,14,21]. Similar techniques have been described for periprosthetic fractures, hip revisions, or complex non-unions [5,11,12,14,19,22].…”

Section: Introductionmentioning

confidence: 99%

“Sandwich technique” in the surgical treatment of primary complex fractures of the femur and humerus

Göğüş

Öztürk

Tezer

et al. 2006

International Orthopaedics (SICO

View full text Add to dashboard Cite

In this prospective study, our aim was to determine the clinical and radiographic outcomes of the surgical treatment of primary complex problem femoral and humeral shaft fractures treated by a new technique called "sandwich technique." A total of 45 patients with comminuted, complex and/or osteopoenic fractures of the femur or humerus (30 femoral and 15 humeral fractures) were treated using this technique. The patients were followed up for a mean of 25 months. In 24 (85.7%) of 28 patients with femoral fractures and in 14 (93.3%) of 15 patients with humeral fractures, union was achieved within 3-6 months of the operation (mean: 4.5 months). The total union rate was 88.4%. The pseudoarthrosis rate was 12%. There was no infection or implant failure seen during the follow-up period. The cortical allograft struts can be used to provide collateral support to weakened osteopoenic/ osteoporotic bone. This technique provides a union rate of about 88% in osteoporotic and/or complex primary humerus or femur fractures.

show abstract

In vivo testing of a biodegradable woven fabric made of bioactive glass fibers and PLGA₈₀—A pilot study in the rabbit

et al. 2010

View full text Add to dashboard Cite

The purpose of this study was to perform an intra-animal comparison of biodegradable woven fabrics made of bioactive glass (BG) fibers and poly(L-lactide-co-glycolide) 80/20 copolymer (PLGA(80)) fibers or PLGA(80) fibers alone, in surgical stabilization of bone graft. The BG fibers (BG 1-98) were aimed to enhance bone growth at site of bone grafting, whereas the PLGA component was intended to provide structural strength and flexibility to the fabric. Bone formation was analyzed qualitatively by histology and quantitatively by peripheral quantitative computed tomography (pQCT) at 12 weeks. The surgical handling properties of the control PLGA(80) fabric were more favorable. Both fabrics were integrated with the cortical bone surfaces, but BG fibers showed almost complete resorption. There were no signs of adverse local tissue reactions. As a proof of material integration and induced new bone formation, there was a significant increase in bone volume of the operated femurs compared with the contralateral intact bone (25% with BG/PLGA(80) fabric, p < 0.001 and 28% with the control PLGA(80) fabric, p = 0.006). This study failed to demonstrate the previously seen positive effect of BG 1-98 on osteogenesis, probably due to the changed resorption properties of BG in the form of fibers. Therefore, the feasibility and safety of BG as fibers needs to be reevaluated before use in clinical applications.

show abstract

Cortical Strut Allografts in the Reconstruction of the Femur in Revision Total Hip Arthroplasty

Cited by 111 publications

References 0 publications

Strut grafts in revision hip arthroplasty faced with femoral bone defects: an experimental analysis

Strut grafts in revision hip arthroplasty faced with femoral bone defects: an experimental analysis

“Sandwich technique” in the surgical treatment of primary complex fractures of the femur and humerus

In vivo testing of a biodegradable woven fabric made of bioactive glass fibers and PLGA₈₀—A pilot study in the rabbit

Contact Info

Product

Resources

About

Cortical Strut Allografts in the Reconstruction of the Femur in Revision Total Hip Arthroplasty

Cited by 111 publications

References 0 publications

Strut grafts in revision hip arthroplasty faced with femoral bone defects: an experimental analysis

Strut grafts in revision hip arthroplasty faced with femoral bone defects: an experimental analysis

“Sandwich technique” in the surgical treatment of primary complex fractures of the femur and humerus

In vivo testing of a biodegradable woven fabric made of bioactive glass fibers and PLGA80—A pilot study in the rabbit

Contact Info

Product

Resources

About

In vivo testing of a biodegradable woven fabric made of bioactive glass fibers and PLGA₈₀—A pilot study in the rabbit