The use of customized cages in revision total hip arthroplasty for Paprosky type III acetabular bone defects

Mao, Yuanqing; Xu, Chen; Xu, Jie; Li, Huiwu; Li, Fengxiang; Zhu, Zhenan

doi:10.1007/s00264-015-2965-6

Cited by 49 publications

(34 citation statements)

References 38 publications

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“…4 The bilobed and customized prostheses with or without bone grafting are also reported to achieve favorable results. 5,6 In contrast, the results of cementless cup implantation by the rim-fit technique without bone grafting are also fairly favorable. 9,10 However, cementless hemispherical cup implantation without bone grafting poses concerns regarding postoperative issues, including high hip center positioning, which may lead to joint instability or unnatural biomechanical condition, poor initial stability of the acetabular component, and residual gap between the acetabular host bone and the acetabular component.…”

Section: Discussionmentioning

confidence: 99%

Midterm results of revision total hip arthroplasty for migrated bipolar hemiarthroplasty in patients with hip osteoarthritis using cementless cup with the rim-fit technique

Tanaka

Kaneko

Hidaka

et al. 2020

J Orthop Surg (Hong Kong)

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Purpose: The results of reamed bipolar hemiarthroplasty (BHA) in patients with hip osteoarthritis (OA) are reported to be unfavorable. Acetabular reaming for sufficient bony coverage caused bipolar head migration into the superomedial direction, and most patients required revision surgeries. Several methods are applicable to treat decreased bone stock. This study aimed to investigate the midterm results of revision surgeries using the cementless cup with the rim-fit technique. Methods: Between 1996 and 2014, acetabular revision surgeries using the cementless cup with the rim-fit technique were performed in 86 hips (74 patients). We evaluated radiographic outcomes, including positional change of the rotation center of the artificial femoral head, presence of implant loosening, and filling of the initial gap. We also evaluated clinical outcomes, including the Harris hip score (HHS), and postoperative complications. Results: The average positional changes from BHA to prerevision surgeries were 8.0 mm superiorly and 4.1 mm medially. The average changes from prerevision to postrevision surgeries were 3.7 mm inferiorly and 2.4 mm laterally. No implant loosening was found in all cases; the initial gap between the acetabular host bone and the acetabular cup was filled in 53 (93%) among 57 hips. The average HHS improved from 65.9 before revision surgeries to 83.8 in the latest follow-up. Dislocation and postoperative periprosthetic fracture occurred in two and five hips, respectively; no cases required rerevision surgeries. Conclusion: There were favorable midterm results of the revision total hip arthroplasty for migrated BHA in patients with hip OA using cementless cup with the rim-fit technique.

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Section: Discussionmentioning

confidence: 99%

Midterm results of revision total hip arthroplasty for migrated bipolar hemiarthroplasty in patients with hip osteoarthritis using cementless cup with the rim-fit technique

Tanaka

Kaneko

Hidaka

et al. 2020

J Orthop Surg (Hong Kong)

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“…Therefore, bone defects reconstruction directly determines the success of THA revision [ 14 ]. Unfortunately, the objectives of restoring or preserving pelvic bone stock, placing the acetabular component to the correct anatomic position to optimize joint stability, equalize leg lengths, and achieve stable fixation are not readily achieved in such a situation [ 3 , 15 , 16 ]. Currently, the methods of bone defects reconstruction mainly include impaction of bone particles graft [ 17 ] and structural bone grafts [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…Autogenous bone and allograft bone are the common source of bone graft. Autogenous bone is an ideal bone graft material as a result of its osteoinductive and osteoconductive capabilities [ 3 , 15 ]. Although autogenous bone could provide osteogenic cells and has neither the immunogenicity nor the risk of disease transmission, its application is significantly restricted by its single source and limited bone mass, especially in the situation when patients suffer massive bone defects.…”

Section: Discussionmentioning

confidence: 99%

“…Although autogenous bone could provide osteogenic cells and has neither the immunogenicity nor the risk of disease transmission, its application is significantly restricted by its single source and limited bone mass, especially in the situation when patients suffer massive bone defects. Allogeneic bone graft is the most widely used material currently [ 15 ]. Its advantages range from abundant and readily available to obtain to well-behaved initial strength.…”

Section: Discussionmentioning

confidence: 99%

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Clinical evaluation following the use of mineralized collagen graft for bone defects in revision total hip arthroplasty

et al. 2015

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Revision total hip arthroplasty (THA) with massive bone loss has been a real challenge for orthopaedic surgeons. Here we describe an approach using mineralized collagen (MC) graft to reconstruct acetabulum and femur with massive bone defects. We identified 89 patients suffering acetabular or femoral bone defects after primary THA, who required revision THA for this study. During the surgery, MC was applied to reconstruct both the acetabular and femoral defects. Harris hip score was used to evaluate hip function while radiographs were taken to estimate bone formation in the defect regions. The average follow-up period was 33.6 ± 2.4 months. None of the components needed re-revised. Mean Harris hip scores were 42.5 ± 3.5 before operation, 75.2 ± 4.0 at 10th month and 95.0 ± 3.6 at the final follow-up. There were no instances of deep infection, severe venous thrombosis or nerve palsy. The present study demonstrated that MC graft can serve as a promising option for revision THA with massive bone deficiency. Meanwhile, extended follow-up is needed to further prove its long-term performance.

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“…For example, Mao et al (46) used 3D models in 22 patients with hip arthroplasty requiring revision surgery. The 3D models were used to fit the surgically altered acetabulum with commercially available cages or custom acetabular cages.…”

Section: Introductionmentioning

confidence: 99%

Clinical Applications of 3D Printing

et al. 2018

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Three-dimensional (3D) printing refers to a number of manufacturing technologies that create physical models from digital information. Radiology is poised to advance the application of 3D printing in health care because our specialty has an established history of acquiring and managing the digital information needed to create such models. The 3D Printing Task Force of the Radiology Research Alliance presents a review of the clinical applications of this burgeoning technology, with a focus on the opportunities for radiology. Topics include uses for treatment planning, medical education, and procedural simulation, as well as patient education. Challenges for creating custom implantable devices including financial and regulatory processes for clinical application are reviewed. Precedent procedures that may translate to this new technology are discussed. The task force identifies research opportunities needed to document the value of 3D printing as it relates to patient care.

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The use of customized cages in revision total hip arthroplasty for Paprosky type III acetabular bone defects

Abstract: The present study demonstrates that a customised cage may be a promising option for THA revision of severely compromised acetabula. Extended follow-up is necessary to evaluate the long-term performance of this approach.

Cited by 49 publications

References 38 publications

Midterm results of revision total hip arthroplasty for migrated bipolar hemiarthroplasty in patients with hip osteoarthritis using cementless cup with the rim-fit technique

Midterm results of revision total hip arthroplasty for migrated bipolar hemiarthroplasty in patients with hip osteoarthritis using cementless cup with the rim-fit technique

Clinical evaluation following the use of mineralized collagen graft for bone defects in revision total hip arthroplasty

Clinical Applications of 3D Printing

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