Phosphocalcium ceramics are efficient in the management of severe acetabular loss in revision hip arthroplasties. A 22 cases long-term follow-up study

Abstract

Management of bone loss in revision total hip replacement remains a challenge. To eliminate any immunological or infectious problem and so to try to improve the long-term results obtained with allografts, the authors used synthetic ceramics as bone substitutes since 1995. We reviewed 13 of the patients of our study, we previously reported in 2005 (Schwartz and Bordei in Eur J Orthop Surg Traumatol 15: 191 2005), which was a prospective cohort of thirty-two cases of acetabular revision reconstruction, with a mean follow-up of 14.4 years yet (from 9 to 16 years). Clinical results were assessed according to Oxford scale and Postel and Merle d'Aubigne (PMA) scale. Since 2005, no specific complications were noted. The average PMA functional hip score was 14.9 (vs. 9.2 before revision) at follow-up over 9 years. Nine patients still alive in 2013 were seen again by a surgeon, which was not the operator, with a mean follow-up of 15.3 years: Their Oxford average score was 40.3. Radiological assessment affirmed a good integration of the substitutes in bone without any edging in all cases. A progressive invasion of the ceramics by bone can be seen on the X-ray. We conclude that about 15 years of average delay, which is a significant follow-up in orthopedic surgery, the outcomes without specific complications are satisfactory and allow one to go with these materials in total hip revision surgery.

Synthetic Bone Grafting in Aseptic Loosening of Acetabular Cup: Good Clinical and Radiological Outcomes in Contained Bone Defects at Medium-Term Follow Up

“…Good osteointegration to native bone was observed in all 40 patients. Schwartz et al [26] used a biphasic phosphor-calcium bone substitute to face severe acetabular bone loss using both jumbo cups and a screwed support ring. At a mean 10 year follow-up, they reported no cases of migration of the cup in living patients and good bone osteointegration.…”

A new percentage of biphasic calcium phosphate (BCP) of nanoparticles synthesized directly by hydrothermal process

“…Due to their high biocompatibility, and similarity to the inorganic bone component and teeth in mammals 4,5 . BCP material combines the physicochemical properties of two elements HA and β-TCP and gives a more efficient composite material 6,7,8 . Recently, BCPs have been recognized as the gold standard of bone substitutes in reconstructive bone surgery 9 .…”