Revision hip arthroplasty using impacted cancellous bone and cement: a long-term follow-up study

Arumugam, Gowthaman; Nanjayan, Shashi Kumar; Quah, Conal; Wraighte, Philip J.; Howard, Peter

doi:10.1007/s00590-015-1703-5

Cited by 5 publications

(3 citation statements)

References 38 publications

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“…The functional outcome scores all improved significantly after surgery and patients reported a high satisfaction rate in accordance with earlier literature (Arumugam et al. 2015 , Te Stroet et al. 2015b ).…”

Section: Discussionsupporting

confidence: 91%

Bone mineral density changes in the graft after acetabular impaction bone grafting in primary and revision hip surgery

et al. 2018

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Background and purposeImpaction bone grafting (IBG) is an established method in hip revision surgery to reconstruct loss of bone stock. There is limited knowledge concerning the actual bone remodelling process within the allograft. We investigated with repeated bone mineral density (BMD) measurements the biological process of bone remodelling in the allograft in vivo. We hypothesized that an initial decrease in BMD would be followed by an increase towards baseline values.Patients and methodsDual-energy X-ray absorptiometry (DXA) was used to measure BMD values in 3 regions of interest (ROI) in 20 patients (average age at surgery 70 years, 11 males) after an acetabular reconstruction with IBG and a cemented cup. A postoperative DXA was used as baseline and DXA was repeated at 3 and 6 months and at 1 and 2 years. The Oxford Hip Score (OHS), the 12-Item Short Form Health Survey (SF12), and a 0 to 100 mm visual analogue scale (VAS) for pain and satisfaction were obtained simultaneously.ResultsThe overall mean BMD in the IBG regions increased significantly by 9% (95% CI 2–15) at 2 years’ follow-up. In the cranial ROI BMD increased 14% (CI 6–22), whereas the BMD in the medial and caudal ROI showed an increase of 10% (CI 1–18) and 4% (CI –6–16), respectively. The OHS, SF12-mental, and VAS for pain all improved statistically significantly 2 years after surgery, with a mean VAS for satisfaction of 77 (CI 63–90) out of 100 points. The SF12-physical showed non-significant improvement.InterpretationThe BMD in the allograft gradually increased after IBG for acetabular reconstruction arthroplasties, particularly in the cranial ROI. An initial decrease in the BMD was not encountered. These BMD changes, as proxy measurements for bone remodeling, may indicate progressive apposition of vital new host bone in the grafted area.

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Section: Discussionsupporting

confidence: 91%

Bone mineral density changes in the graft after acetabular impaction bone grafting in primary and revision hip surgery

et al. 2018

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“…In this series, the success rate of bone graft impaction was excellent [19 out of 20 patients; 95%], following at least 2 years of follow up. Arumugam et al [13] studied sequential 64 cup revision with follow-up period of 10 years, with survival rate of the graft being 95.5%. Verspeek et al [14] reported higher failure rate [27%; 13 out of 44] in their 15 years follow-up study.…”

Section: Discussionmentioning

confidence: 99%

Impacted Bone Graft in Revision Acetabulum Surgery: A clinical experience

Said

2022

International Journal of Medical Arts

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Article informationBackground: With the advancement of hip surgery and increased life span in many nations, the need for acetabular revision surgery is expected to grow. Many options are available for such surgery, including the use of impacted bone graft.The Aim of The Work: This work aimed to assess the clinical results of impacted bone graft in reconstructing the acetabular bone defect after a failed hip surgery.Patients and Methods: Between 2013 and 2019, we performed reconstructions of the acetabulum for 20 patients, who had at least one acetabular operation before revision. Surgical reconstruction was conducted using an impacted cancellous bone graft. Each patient was directed to long-term clinical [primary outcome] and radiological evaluations. The direct postoperative clinical and radiographic outcomes were evaluated and the patient continued regular follow up visits for at least 12 months after surgery. Results: According to the modified Harris-Hip [MHH] score, the results rated as excellent [35%], good [25%], fair [25%] and poor [15%]. No pain was recorded for 40%, slight pain for 30%. Thirteen patients [65%] were able to walk alone without support, while the remaining 7 used a support in the form of a cane [25%] or crutches [10%]. Leg-length discrepancy [>2.5 cm] was reported in two patients. Conclusion:Successful results were obtained using the impaction technique for acetabular reconstruction, with restoration of near normal mechanics. The union rate is satisfactory. Augmentation of the grafting technique by mesh or rings added more stability to the cup component.

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“…11 IBG is a well-established surgical technique pioneered by the Nijmegen 12 and Exeter 13 Group; a technique that can restore deficient acetabular bone stock and recreate anatomic center of rotation with a standard size acetabular socket even in Paprosky 3 and AAOS type III defects with favorable survivorships. 9,10,[14][15][16] Due to aseptic loosening, the survivorship of acetabular components in IBG ranged from 100% at 10 years 17 to 85% after 20 years and 77% after 25 years. 18 Only by restoring bone stock, future revisions and re-revisions can be undertaken with ease.…”

Section: Introductionmentioning

confidence: 99%

Impaction Bone Grafting with Low Dose Irradiated Freeze‐Dried Allograft Bone for Acetabular Reconstruction

Tan

et al. 2022

Orthopaedic Surgery

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Objective: Reconstruction of acetabular defects has been extremely challenging in both primary and revision total hip arthroplasty (THA). Impaction bone grafting (IBG) can restore the acetabulum bone mass and anatomically reconstruct the acetabulum. Our study aimed to report the short and medium-term clinical and radiographic outcomes of IBG for acetabular reconstruction in the cemented THA in the Chinese population.Methods: This was a single-center retrospective review enrolling 57 patients between May 2013 and July 2019. The patients with acetabular defects were treated with IBG, using low dose irradiated freeze-dried allograft bone with or without autograft bone, in the cemented THA performed by one senior surgeon. Harris hip score (HHS), standard pelvis anterior-posterior radiograph and lateral hip radiograph were obtained before operation and at 1 week, 3 months, 12 months, and yearly. Graft osteointegration was evaluated by Oswestry's criteria, and complication was documented at the last follow-up. Independent sample ANOVA test and Pearson chi-square tests are used for statistical analysis.Results: There were 61 hips in 57 patients. The average follow-up time was 35.59 months (5-77 months). According to AAOS classification, a total of 18 hips were identified as segmental bone deficiency (type I), with 21 and 22 hips for cavitary bone deficiency (type II) and the combined bone deficiency (type III), respectively. The average HHS was improved from 44.49 (range: 32-58) preoperatively to 86.98 (range: 78-93) postoperatively. Graft osteointegration was satisfactory (Oswestry score ≥2) in all patients. No dislocation occurred in the 57 patients (61 hips) during followup. Although one cup migrated, no revision, re-revision, radiographic loosening, graft bone lysis, or postoperative complications were detected at the final follow-up.Conclusions: IBG with low-dose irradiated freeze-dried allograft bone in acetabular bone defect reconstruction is a reliable technique for restoring acetabular bone defects in THA.

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Revision hip arthroplasty using impacted cancellous bone and cement: a long-term follow-up study

Cited by 5 publications

References 38 publications

Bone mineral density changes in the graft after acetabular impaction bone grafting in primary and revision hip surgery

Bone mineral density changes in the graft after acetabular impaction bone grafting in primary and revision hip surgery

Impacted Bone Graft in Revision Acetabulum Surgery: A clinical experience

Impaction Bone Grafting with Low Dose Irradiated Freeze‐Dried Allograft Bone for Acetabular Reconstruction

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