The biological acetabular reconstruction with bone allografts in hip revision arthroplasty

Busanelli, L; Castagnini, Francesco; Bordini, Barbara; Stea, Susanna; Calderoni, P; Toni, Aldo

doi:10.1007/s12306-018-0573-5

Cited by 7 publications

(9 citation statements)

References 20 publications

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“…ORTHOTEP University HS Carl Gustav Carus [ 109 , 619 ] 2. Dresden Hip Surgery Registry [ 52 , 196 ] Heidelberg University of Heidelberg [ 410 ] Regensburg Regensburg University [ 198 , 255 , 292 , 296 , 299 ] Greece Athens General HS KAT [ 155 , 384 , 646 ] Thessaloniki Arthroplasty RG Thessaloniki (ART) [ 2 , 12 , 406 , 455 , 647 ] Italy Emilia-Romanga Register of Orthopaedic Prosthetic Implant (RIPO) [ 24 , 26 , 39 , 43 , 57 , 145 , 164 , 189 , 231 , 288 , 297 , 468 , 476 , 482 , 491 , 502 , 506 , 508 , 527 , 540 , 562 , 563 , 569 , 585 , 592 , 597 , …”

Section: Resultsmentioning

confidence: 99%

Global mapping of institutional and hospital-based (Level II–IV) arthroplasty registries: a scoping review

Zgouridou,

Kenanidis,

Potoupnis

et al. 2023

Eur J Orthop Surg Traumatol

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Purpose Four joint arthroplasty registries (JARs) levels exist based on the recorded data type. Level I JARs are national registries that record primary data. Hospital or institutional JARs (Level II–IV) document further data (patient-reported outcomes, demographic, radiographic). A worldwide list of Level II–IV JARs must be created to effectively assess and categorize these data. Methods Our study is a systematic scoping review that followed the PRISMA guidelines and included 648 studies. Based on their publications, the study aimed to map the existing Level II–IV JARs worldwide. The secondary aim was to record their lifetime, publications’ number and frequency and recognise differences with national JARs. Results One hundred five Level II–IV JARs were identified. Forty-eight hospital-based, 45 institutional, and 12 regional JARs. Fifty JARs were found in America, 39 in Europe, nine in Asia, six in Oceania and one in Africa. They have published 485 cohorts, 91 case-series, 49 case–control, nine cross-sectional studies, eight registry protocols and six randomized trials. Most cohort studies were retrospective. Twenty-three per cent of papers studied patient-reported outcomes, 21.45% surgical complications, 13.73% postoperative clinical and 5.25% radiographic outcomes, and 11.88% were survival analyses. Forty-four JARs have published only one paper. Level I JARs primarily publish implant revision risk annual reports, while Level IV JARs collect comprehensive data to conduct retrospective cohort studies. Conclusions This is the first study mapping all Level II–IV JARs worldwide. Most JARs are found in Europe and America, reporting on retrospective cohorts, but only a few report on studies systematically.

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Section: Resultsmentioning

confidence: 99%

Global mapping of institutional and hospital-based (Level II–IV) arthroplasty registries: a scoping review

Zgouridou,

Kenanidis,

Potoupnis

et al. 2023

Eur J Orthop Surg Traumatol

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“…In the UK, 10% of RHAs require further revision,1 with the most common reason being aseptic loosening (39% of cases) 5. The use of an IBG during an RHA further increases the risk of aseptic loosening due to poor graft incorporation, infection and acetabular cup loosening 6. If acetabular graft incorporation could be improved, then there is potential to increase the success of RHA and reduce the number of further revisions 7…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness of decellularised bone allograft compared with fresh-frozen bone allograft for acetabular impaction bone grafting during a revision hip arthroplasty in the UK

Cowell,

Statham,

Sagoo

et al. 2023

BMJ Open

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ObjectivesFresh-frozen allograft is the gold-standard bone graft material used during revision hip arthroplasty. However, new technology has been developed to manufacture decellularised bone with potentially better graft incorporation. As these grafts cost more to manufacture, the aim of this cost-effectiveness study was to estimate whether the potential health benefit of decellularised bone allograft outweighs their increased cost.Study designA Markov model was constructed to estimate the costs and the quality-adjusted life years of impaction bone grafting during a revision hip arthroplasty.SettingThis study took the perspective of the National Health Service in the UK.ParticipantsThe Markov model includes patients undergoing a revision hip arthroplasty in the UK.InterventionImpaction bone grafting during a revision hip arthroplasty using either decellularised bone allograft or fresh-frozen allograft.MeasuresOutcome measures included: total costs and quality-adjusted life years of both interventions over the lifetime of the model; and incremental cost-effectiveness ratios for both graft types, using base case parameters, univariate sensitivity analysis and probabilistic analysis.ResultsThe incremental cost-effectiveness ratio for the base case model was found to be £270 059 per quality-adjusted life year. Univariate sensitivity analysis found that changing the discount rate, the decellularised bone graft cost, age of the patient cohort and the revision rate all had a significant effect on the incremental cost-effectiveness ratio.ConclusionsAs there are no clinical studies of impaction bone grafting using a decellularised bone allograft, there is a high level of uncertainty around the costs of producing a decellularised bone allograft and the potential health benefits. However, if a decellularised bone graft was manufactured for £2887 and lowered the re-revision rate to less than 64 cases per year per 10 000 revision patients, then it would most likely be cost-effective compared with fresh-frozen allograft.

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“…Osseointegrative signals are muted for many reasons, including inhibitive inflammatory state created by particulate wear debris phenomenon, compromised local vascularity, excess mechanical bone loads as a result of regional bone loss, and inadequate surgical preparation of the recipient site. [15][16][17] For this study, we present a retrospective review of the hybrid BGS Cerament, used in acetabular revision surgery in the setting of significant structural and cavitary bony defects. We review serial radiographs to rate the extent of radiological remodeling of the BGS placed into the acetabular region.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Biphasic bone graft substitute in revision total hip arthroplasty with significant acetabular bone defects

McPherson¹,

Stavrakis²,

Chowdhry

et al. 2022

Bone & Joint Open

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Aims Large acetabular bone defects encountered in revision total hip arthroplasty (THA) are challenging to restore. Metal constructs for structural support are combined with bone graft materials for restoration. Autograft is restricted due to limited volume, and allogenic grafts have downsides including cost, availability, and operative processing. Bone graft substitutes (BGS) are an attractive alternative if they can demonstrate positive remodelling. One potential product is a biphasic injectable mixture (Cerament) that combines a fast-resorbing material (calcium sulphate) with the highly osteoconductive material hydroxyapatite. This study reviews the application of this biomaterial in large acetabular defects. Methods We performed a retrospective review at a single institution of patients undergoing revision THA by a single surgeon. We identified 49 consecutive patients with large acetabular defects where the biphasic BGS was applied, with no other products added to the BGS. After placement of metallic acetabular implants, the BGS was injected into the remaining bone defects surrounding the new implants. Patients were followed and monitored for functional outcome scores, implant fixation, radiological graft site remodelling, and revision failures. Results Mean follow-up was 39.5 months (36 to 71), with a significant improvement in post-revision function compared to preoperative function. Graft site remodelling was rated radiologically as moderate in 31 hips (63%) and strong in 12 hips (24%). There were no cases of complete graft site dissolution. No acetabular loosening was identified. None of the patients developed clinically significant heterotopic ossification. There were twelve reoperations: six patients developed post-revision infections, three experienced dislocations, two sustained periprosthetic femur fractures, and one subject had femoral component aseptic loosening. Conclusion Our series reports bone defect restoration with the sole use of a biphasic injectable BGS in the periacetabular region. We did not observe significant graft dissolution. We emphasize that successful graft site remodelling requires meticulous recipient site preparation. Cite this article: Bone Jt Open 2022;3(12):991–997.

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The biological acetabular reconstruction with bone allografts in hip revision arthroplasty

Cited by 7 publications

References 20 publications

Global mapping of institutional and hospital-based (Level II–IV) arthroplasty registries: a scoping review

Global mapping of institutional and hospital-based (Level II–IV) arthroplasty registries: a scoping review

Cost-effectiveness of decellularised bone allograft compared with fresh-frozen bone allograft for acetabular impaction bone grafting during a revision hip arthroplasty in the UK

Biphasic bone graft substitute in revision total hip arthroplasty with significant acetabular bone defects

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