Revision hip arthroplasty with the use of cement and impaction grafting. Histological analysis of four cases.

Nelissen, Rob G H H; Bauer, Thomas W.; Weidenhielm, Lars; LeGolvan, D P; Mikhail, W. E. M.

doi:10.2106/00004623-199503000-00011

Cited by 196 publications

(87 citation statements)

References 19 publications

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“…However, few studies have dealt with the incorporation on histological examination, and the correlation between radiography and the histological finding is unclear (Gordon et al 1985). In clinical reports on histological analysis of the allografts , Heekin et al 1995, Nelissen et al 1995, Ullmark and Linder 1998, a picture similar to ours is seen, with islands of regenerating living bone, mixed with areas of necrotic remnants of the graft but with no signs of remodeling. Even though a very osteogenic material was used in our study, i.e., autologous cancellous graft, we found little, if any, remodeling in the center of the fractured vertebral body as long as 18-20 months after the operation.…”

Section: Discussionmentioning

confidence: 52%

Incomplete incorporation of morselized and impacted autologous bone graft: A histological study in 4 intracorporally grafted lumbar fractures

Tägil

Johnsson

Strömqvist

et al. 1999

Acta Orthopaedica Scandinavica

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Section: Discussionmentioning

confidence: 52%

Incomplete incorporation of morselized and impacted autologous bone graft: A histological study in 4 intracorporally grafted lumbar fractures

Tägil

Johnsson

Strömqvist

et al. 1999

Acta Orthopaedica Scandinavica

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“…The advocates of this stem design in revision with impacted allograft have suggested that the design permits gradual subsidence of the implant within the cement mantle because of plastic deformation of the cement and even viscoelastic deformation of the graft [10]. This leads to a self-tightening that allows restabilisation within the cement [4,9] and provides a beneficial compressive load to the allograft [19]. However, other authors question whether subsidence of a polished stem can be beneficial or if relatively high subsidence of a stem can lead to clinical failures [3,15,16].…”

Section: Discussionmentioning

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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“…The histological findings in biopsies from 4 patients the second year after impaction have been reported (Nelissen et al 1995). Morphological studies of graft material from biopsies and autopsies of 14 patients, of which 5 were done in the first year after surgery, have also been described (Linder 2000).…”

mentioning

confidence: 99%

Rapid bone and blood flow formation in impacted morselized allograftsPositron emission tomography (PET) studies on allografts in 5 femoral component revisions of total hip arthroplasty

Sørensen

Ullmark

Långström

et al. 2003

Acta Orthopaedica Scandinavica

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Revision hip arthroplasty with the use of cement and impaction grafting. Histological analysis of four cases.

Cited by 196 publications

References 19 publications

Incomplete incorporation of morselized and impacted autologous bone graft: A histological study in 4 intracorporally grafted lumbar fractures

Incomplete incorporation of morselized and impacted autologous bone graft: A histological study in 4 intracorporally grafted lumbar fractures

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

Rapid bone and blood flow formation in impacted morselized allograftsPositron emission tomography (PET) studies on allografts in 5 femoral component revisions of total hip arthroplasty

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