Massive allografting for severe failed total hip replacement.

McGann, William A.; Mankin, Henry J.; Harris, William H.

doi:10.2106/00004623-198668010-00002

Cited by 70 publications

(17 citation statements)

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“…Augmentation of autograft in the filling of massive bony defects in reconstructive hip surgery has been tried with allograft (Borja and Mnaymneh 1985, Gross et al 1985, McGann et al 1986, Garbuz et al 1996, Gross 1999. Oonishi et al (1997) described their experience with filling of acetabular defects using hydroxyapatite granules secured with a layer of cement under a cemented acetabular component.…”

Section: Discussionmentioning

confidence: 99%

Poor results after augmenting autograft with xenograft (Surgibone) in hip revision surgery

2005

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Background Surgibone Unilab is prepared from bovine bone and contains hydroxyapatite and protein. It is supposed to be immunogenically inert but the protein could be antigenic in man.Patients and methods We followed 27 patients for an average of 2.5 (1-5) years, all of whom had received Surgibone mixed with autograft to fill in defects in the acetabulum and the proximal femur in revision hip surgery.Results In 17 patients, there was apparently complete incorporation of the bone graft within 6 months. In 3 of these patients, the graft was incorporated after 3 months. In 3 patients, however, there was no incorporation of the graft as late as 3 years after the operation. 3 other patients appeared to have a type of graft rejection (pseudoinfection). 1 other patient suffered MRSA deep infection of the prosthesis which resulted in removal of the implants 1 month postoperatively.Interpretation Use of Surgibone xenograft in revision hip surgery, even in combination with autograft, resulted in failure and the need for rerevision in at least one quarter of the cases studied.

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Section: Discussionmentioning

confidence: 99%

Poor results after augmenting autograft with xenograft (Surgibone) in hip revision surgery

2005

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“…Bone grafting, either homologous or autologous, used increasingly in revision operations [10,16,17,27] and in periprosthetic fractures is capable of building up bone stock in the proximal femur. The histology in our cases demonstrated the presence of normal bone.…”

Section: Discussionmentioning

confidence: 99%

Uncemented revision stem for biological osteosynthesis in periprosthetic femoral fractures

Eingartner¹,

Volkmann²,

Putz³

et al. 1997

International Orthopaedics

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“…The instability of the attachment of the hip abductors resulted in decreased limb use. Failure of the greater trochanter to unite with the allograft has been reported before and occurred during hip revisions using a proximal femoral APC in two of three patients in one report 43 and in 22 of 45 patients that had the trochanter secured with the cable grip system in another. 35 Interestingly, 14 of these 22 patients also had trochanteric escape or displacement with an intact cable grip.…”

Section: Discussionmentioning

confidence: 88%

Gluteal muscle attachment during proximal femoral reconstruction in a canine model

Pluhar¹,

Manley²,

Heiner³

et al. 2006

Journal Orthopaedic Research

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In this 18 month in vivo canine study we compared three methods of attaching the gluteal muscles to the proximal femur during hip reconstruction with an allograft-prosthesis composite (APC). All three methods are commonly practiced in human hip revision surgery and data on their effectiveness in dogs is directly relevant to human treatment. The methods compared were host gluteal tendon sutured to allograft tendon, host greater trochanter apposed to allograft using a cable grip system, and host cortical bone shells around the allograft secured with cerclage wires. For each method, we assessed changes in allograft-host bone fusion, weight bearing, gluteal muscle mass, and structural properties through qualitative radiography, gait analysis, histology, and biomechanical testing. Hip reconstruction using the WRAP method resulted in the greatest limb use with complete resolution of gluteal muscle atrophy 18 months after surgery. This method yielded a stronger, more stable hip joint that allowed for more normal limb function. These hips had the more rapid rate of bony union at the host bone-allograft junction and little resorption of the graft. The increased limb use and resultant larger gluteal muscle mass conferred to the WRAP hip composites the greatest tensile strength and stiffness when tested 18 months after reconstruction. There was a large amount of new bone formation on the periosteal surface where the WRAP reconstructions had an overlay of live bone that resulted in a more rapid union and increased cortical width at the level of the osteotomy. New bone also penetrated into the allograft a greater distance from the osteotomy in the WRAP group. ß

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Massive allografting for severe failed total hip replacement.

Cited by 70 publications

References 0 publications

Poor results after augmenting autograft with xenograft (Surgibone) in hip revision surgery

Poor results after augmenting autograft with xenograft (Surgibone) in hip revision surgery

Uncemented revision stem for biological osteosynthesis in periprosthetic femoral fractures

Gluteal muscle attachment during proximal femoral reconstruction in a canine model

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