Impaction allografting with cement for extensive femoral bone loss in revision hip surgery: A 4- to 8-year follow-up study

Fetzer, Gary B.; Callaghan, John J.; Templeton, Jesse E.; Goetz, Devon D.; Sullivan, Patrick M.; Johnston, Richard C.

doi:10.1054/arth.2001.29136

Cited by 56 publications

(26 citation statements)

References 15 publications

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“…The advantage of this method of femoral reconstruction over others is that it potentially allows for the recovery of bone stock in deficient femora since the compacted allograft chips may be incorporated and subsequently remodelled in the host skeleton. Since the original report, a number of authors have published favourable results, [4][5][6][7][8][9][10][11][12][13][14][15] though others have recorded significant problems. [16][17][18][19][20] The technique used in Exeter has evolved since that reported in the original series.…”

Section: Introductionmentioning

confidence: 99%

Femoral impaction grafting with cement in revision total hip replacement

Halliday¹,

English²,

Timperley³

et al. 2003

The Journal of Bone and Joint Surgery. British volume

199

140

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e report the results of cancellous femoral impaction grafting with cement in revision hip arthroplasty in all patients from one centre who had undergone surgery more than five years previously. A total of 32 surgeons undertook femoral impaction grafting in 207 patients (226 hips). There were no deaths attributable to the revision surgery; 33 patients with 35 functioning hips died with less than five years' follow-up. One patient was lost to follow-up. Two hips (1%) developed early postoperative infection. Of the 12 stems which underwent a further surgical procedure for aseptic failure, ten were for femoral fracture and two for loosening.Survivorship with any further femoral operation as the endpoint was 90.5% (confidence intervals, 82 to 98) and using femoral reoperation for symptomatic aseptic loosening as the endpoint, the survivorship was 99.1% (confidence intervals, 96 to 100) at 10 to 11 years. As a consequence of the experience in this series, we have modified our technique with an increased use of longer stems with impacted allograft. Long stems are indicated when the host bone around the tip of a short stem is compromised, in patients with major loss of bone stock, or when a femoral fracture occurs.

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Section: Introductionmentioning

confidence: 99%

Femoral impaction grafting with cement in revision total hip replacement

Halliday¹,

English²,

Timperley³

et al. 2003

The Journal of Bone and Joint Surgery. British volume

199

140

View full text Add to dashboard Cite

show abstract

“…It subsequently allows the incorporation and remodelling of living bone stock in the host skeleton. Based on the original reports [9], a number of authors have published favourable results [7,13,18,24,25], though others have reported serious problems [3,15,16,20]. Furthermore, the technique used with the Exeter stem has evolved since it was first reported in the original series [9,21].…”

Section: Introductionmentioning

confidence: 99%

Impaction allograft with cement for the revision of the femoral component. A minimum 39-month follow-up study with the use of the Exeter stem in Asian hips

Yim

Kim

Suh

2006

International Orthopaedics (SICOT)

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We report the results of impaction bone grafting of the femoral side in revision total hip arthroplasty in Asian hips (South Korean patients) in which the surgery was performed with the Exeter stem. The minimum follow-up was 39 months (mean, 48.4; range, 39-66). There was subsidence of the cement-graft interface (<1 mm) in three hips (5%), of the stem-cement interface (<1 mm) in 12 hips (21%) and of the stem-cement interface (1-2 mm) in 14 hips (25%). Five hips (9%) developed intraoperative femoral fracture and two hips (4%) femoral perforation in revision. The complications of femoral fracture and subsidence did not have an adverse effect on the final clinical outcomes. The impaction of fresh-frozen allograft and use of a cemented, polished, tapered stem (Exeter stem) were also successful with good clinical and radiographic outcomes in our study of Asian hips (South Korean patients). However, we used smaller stems than the usual ones used for Western patients because of the smaller femur sizes.Résumé Nous reportons les résultats de la technique d'Exeter avec greffons impactés dans les reprises totales de hanche, étude réalisée sur des hanches asiatiques et sur des patients sud coréens, avec utilisation de la tige d'Exeter.Le suivi minimum a été de 39 mois (48.4 à 39.66). La migration à l'interface ciment greffe a été inférieure à 1 mm dans 3 cas, 5%. A l'interface tige ciment, (<1 mm) dans 12 hanches (21% des cas) et enfin à l'interface tige ciment, cette migration est comprise entre 1 et 2 mm dans 14 hanches (25% des cas). 5 hanches (11%) ont présenté durant l'intervention des complications avec une fracture fémorale dans 5 cas (9%) et une perforation fémorale dans 2 cas (4%). Ces complications ainsi que la migration de la tige n'ont pas entraîné de problèmes cliniques. La technique utilisant des allogreffes compactées cryoconservées et l'utilisation d'une tige cimentée et polie de type Exeter ont donné, dans cette étude, de bons résultats, tant sur le plan clinique que sur le plan radiographique. Cependant, nous avons dû utiliser des tiges beaucoup plus petites qu'habituellement en Europe compte tenu de la petite taille des fémurs asiatiques sud coréens.

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“…High survival and functional scores have been reported with the use of impaction bone grafting and metal meshes in segmental defects [14,25,39,40]. We observed circumferential metal meshes, impaction bone grafts, and long cemented triple-tapered femoral stems presented a favorable initial resistance, reaching more than 600 kg to axial forces in bovine femurs [18].…”

Section: Discussionmentioning

confidence: 58%

“…Impaction bone grafting has become an accepted technique to treat severe femoral bone loss during complex revision total hip arthroplasty (THA) procedures [14,23,25,34,37,40]. One of the essential requisites for this method is containment of the impacted cancellous bone within the medullary cavity.…”

Section: Introductionmentioning

confidence: 99%

Proximal Femoral Reconstructions with Bone Impaction Grafting and Metal Mesh

Buttaro

Piccaluga

2009

Clinical Orthopaedics &Amp; Related Research

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Extensive circumferential proximal cortical bone loss is considered by some a contraindication for impaction bone grafting in the femur. We asked whether reconstruction with a circumferential metal mesh, impacted bone allografts, and a cemented stem would lead to acceptable survival in these patients. We retrospectively reviewed 14 patients (15 hips) with severe proximal femoral bone defects (average, 12 cm long; 14 type IV and one type IIIB using the classification of Della Valle and Paprosky) reconstructed with this method. The minimum followup was 20 months (average, 43.2 months; range, 20-72 months). Preoperative Merle D'Aubigné and Postel score averaged 4.8 points. With revision of the stem as the end point, the survivorship of the implant was 100% at one year and 86.6% at 72 months. The mean functional score at last followup was 14.4 points. We observed two fractures of the metal mesh at 31 and 48 months in cases reconstructed with a stem that did not bypass the mesh. Dislocation (3 cases) and acute deep infection (3 cases) were the most frequent complications. Patients with com-

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Impaction allografting with cement for extensive femoral bone loss in revision hip surgery: A 4- to 8-year follow-up study

Cited by 56 publications

References 15 publications

Femoral impaction grafting with cement in revision total hip replacement

Femoral impaction grafting with cement in revision total hip replacement

Impaction allograft with cement for the revision of the femoral component. A minimum 39-month follow-up study with the use of the Exeter stem in Asian hips

Proximal Femoral Reconstructions with Bone Impaction Grafting and Metal Mesh

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