Impaction bone-grafting of severely defective femora in revision total hip surgery: 21 hips followed for 41-85 months

Biezen, F. C. van; Have, B. L. E. F. ten; Verhaar, Jan A N

doi:10.1080/000164700317413094

Cited by 90 publications

(53 citation statements)

References 22 publications

(24 reference statements)

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“…Impaction grafting is another well-described technique that has some success in patients with femoral bone loss [17,21,32]. While radiographic and histologic studies have suggested neovascularization of impacted allograft bone in the proximal femur [22], when there is substantial segmental bone loss, concerns regarding prosthesis migration and periprosthetic fracture remain [24,25].…”

Section: Discussionmentioning

confidence: 99%

Revision of the Deficient Proximal Femur With a Proximal Femoral Allograft

Safir

Kellett²,

Flint

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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Substantial bone loss is frequently encountered with revision hip arthroplasty. A proximal femoral allograft may be used to reconstitute bone stock in the multiply revised femur with segmental bone loss of greater than 5 cm. We retrospectively reviewed 92 patients (93 hips) who underwent such proximal femoral allografts. The average age at the surgery was 61 years. The average number of previous revision procedures was 2.5. Six patients were lost to followup. Thirty-four of 36 deceased patients had the original proximal femoral allograft at the time of death. The minimum followup for the 50 remaining patients was 15 years (average, 16.2 years; range, 15-22 years).

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Section: Discussionmentioning

confidence: 99%

Revision of the Deficient Proximal Femur With a Proximal Femoral Allograft

Safir

Kellett²,

Flint

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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“…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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“…However, stem subsidence of greater than 5 mm and up to 31 mm [9,15,18,24,25,33,41,42] and postoperative femoral fracture with a prevalence of up to 15% [6,10,12,25,29] have been reported for femoral IBG in rTHA.…”

Section: Introductionmentioning

confidence: 99%

Reduced Femoral Component Subsidence with Improved Impaction Grafting at Revision Hip Arthroplasty

Howie

Callary

McGee

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background Despite stem subsidence being a major complication of femoral impaction bone grafting in cemented revision hip arthroplasty, few studies have distinguished subsidence at the prosthesis-cement interface from that at the cement-bone interface. It is unknown how technique developments intended to improve the procedure influence stability of the stem. Questions/purposes We used a sensitive technique to measure subsidence of a cemented polished collarless double-taper stem at each interface after femoral impaction grafting and compared subsidence, radiographic loosening, complications, and reoperations over three series of hips defined by technique developments. Patients and Methods Three series were defined: Series 1 (n = 23, irradiated allograft), Series 2 (n = 12, doublewashed, size-profiled graft, nonirradiated bone, long stems as required), and Series 3 (n = 21, modular tamps). Stem subsidence was analyzed with Ein Bild Röntgen Analyse software. Radiographic loosening, complications, and reoperations were also determined. Results The median subsidence at 12 months for Series 1, 2, and 3 were 2.1, 0.5, and 0.7 mm at the prosthesis-cement interface and 1.3, 0

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Impaction bone-grafting of severely defective femora in revision total hip surgery: 21 hips followed for 41-85 months

Cited by 90 publications

References 22 publications

Revision of the Deficient Proximal Femur With a Proximal Femoral Allograft

Revision of the Deficient Proximal Femur With a Proximal Femoral Allograft

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

Reduced Femoral Component Subsidence with Improved Impaction Grafting at Revision Hip Arthroplasty

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