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

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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.

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References

  1. Schwartz C, Bordei R (2005) Biphasic phospho-calcium ceramics used as bone substitutes are efficient in the management of severe acetabular bone loss in revision total hip arthroplasties. Eur J Orthop Surg Traumatol 15:191

    Article  Google Scholar 

  2. Goldring SR, Schiller AL, Roelke MS, Rourke CM, Harris WH (1983) The synovial-like membrane at the bone cement interface in loose total hip replacements. J Bone Joint Surg 65A:575–584

    Google Scholar 

  3. Linder L, Lindberg L, Carlsson A (1983) Aseptic loosening of hip prostheses. A histologic and enzyme histochemical study. Clin Orthop 175:93–104

    PubMed  Google Scholar 

  4. Jasty MJ, Floyd WE, Schiller AL, Goldring SR, Harris WH (1986) Localized osteolysis in stable, non-septic total hip replacement. J Bone Joint Surg 68A:912–919

    Google Scholar 

  5. Howie D, Oakeshott R, Manthy B, Vernon-Roberts B (1987) Bone resorption in the presence of polyethylene wear particles. J Bone Joint Surg 69B:165

    Google Scholar 

  6. Hunter GA, Welsh RP, Cameron HU, Bailey WH (1979) The results of revision of total hip arthroplasty. J Bone Joint Surg 61B:419–421

    Google Scholar 

  7. Kavanagh BK, Ilstrup DM, Fitzgerald RH Jr (1985) Revision total hip arthroplasty. J Bone Joint Surg 67A:517–526

    Google Scholar 

  8. Wilson MG, Scott RD (1987) Reconstruction of the deficient acetabulum using the bipolar socket. Clin Orthop 251:126–133

    Google Scholar 

  9. Mallory TH, Vaughn BK, Lombardi AV Jr, Reynolds HM Jr, Koenig JA (1988) Treated acetabular components: design rationale and preliminary clinical experience. Orthop Rev 17(3):305–314

    CAS  PubMed  Google Scholar 

  10. Murray WR (1990) Acetabular salvage in revision total hip arthroplasty using the bipolar prosthesis. Clin Orthop 251:92–99

    PubMed  Google Scholar 

  11. Paprosky WG, Magnus RE (1994) Principles of bone grafting in revision total hip arthroplasty. Acetabular technique. Clin Orthop 298:147–155

    PubMed  Google Scholar 

  12. Gross AE, Lavoie MV, McDermott MP (1985) The use of allograft bone in revision total hip arthroplasty. Clin Orthop 197:115–122

    PubMed  Google Scholar 

  13. Trancik TM, Stulberg BN, Wilde AH, Feiglin DH (1986) Allograft reconstruction of the acetabulum during revision total hip arthroplasty clinical, radiographic, and scintigraphic assessment of the results. J Bone Joint Surg 68A:527–533

    Google Scholar 

  14. Allan DG, Lavoie GJ, McDonald S, Oakeshott R, Gross AE (1991) Proximal femoral allografts in revision hip arthoplasty. J Bone Joint Surg 73B:235–240

    Google Scholar 

  15. De Groot K (1983) Ceramics of calcium phosphates : preparation and properties. In: Bioceramics of calcium phosphate. CRC Press, Boca Raton, p 100

  16. Heughebaert M, LeGeros RZ, Gineste M, Guilhem A, Bonel G (1988) Physicochemical characterization of deposits associated with HA ceramics implanted in nonosseous sites. J Biomed Mater Res 22(Suppl 3):257–368

    Article  CAS  PubMed  Google Scholar 

  17. Daculsi G, LeGeros RZ, Nery E, Lynch K, Kerebel B (1989) Transformation of biphasic calcium phosphate ceramics in vivo: ultrastructural and physicochemical characterization. J Biomed Mater Res 23(8):883–894

    Article  CAS  PubMed  Google Scholar 

  18. Yamada Y, Heymann D, Bouler JM, Daculsi G (1997) Osteoclastic resorption of calcium phosphate ceramics with different HA -bTCP ratios. Biomaterials 18:1037–1041

    Article  CAS  PubMed  Google Scholar 

  19. D’Antonio JA, Capello WN, Borden LS (1989) Classification and management of acetabular abnormalities in total hip arthroplasty. Clin Orthop 243:126–137

    PubMed  Google Scholar 

  20. Murray DW, Fitzpatrick R, Rogers K, Pandit H, Beard DJ, Carr AJ, Dawson J (2007) The use of the oxford hip and knee scores. J Bone Joint Surg Br 89(B8):101–1014

    Google Scholar 

  21. Frayssinet P, Schwartz C (1998) Histological study of calcium phosphate ceramics implanted in human long bones. In: LeGeros RZ, LeGeros JP (eds) Bioceramics 11. World Scientific Publishing Co Ltd, Singapore, pp 353–357

    Google Scholar 

  22. Schwartz C, Liss P, Jacquemaire B, Lecestre P, Frayssinet P (1999) Biphasic synthetic bone substitute use in orthopedic and trauma surgery. J Mater Sci Mater Med 10:821–825

    Article  CAS  PubMed  Google Scholar 

  23. Oonishi H, Iwaki H, Kin N, Kushitani S, Murata N, Wakitani S, Imoto K (1997) Hydroxyapatite in revision of total hip replacement with massive acetabular defects. J Bone Joint Surg 79B:87

    Article  Google Scholar 

  24. Levai JP, Boisgard S (1996) Acetabular reconstruction in total hip revision using a bone graft substitute: early clinical and radiographic results. Clin Orthop 330:108–144

    Article  PubMed  Google Scholar 

  25. Kwong LM, Jasty M, Harris WH (1993) High failure rate of bulk femoral head allografts in total hip acetabular reconstructions at 10 years. J Arthroplast 8(4):34–341

    Google Scholar 

  26. Zheng MH, Laird R, Xu J, Wood D (2002) Mechanism of bone allograft failure. J Bone Joint Surg 84B(supp III):234

    Google Scholar 

  27. Linder L (2000) Cancellous impaction grafting in the human femur. Histological and radiographic observations in 6 autopsy femurs and 8 biopsies. Acta Orthop Scand 71(6):543–552

    Article  CAS  PubMed  Google Scholar 

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Conflict of interest

Dr. Schwartz reports other from null, outside the submitted work. Dr. Vautrin has nothing to disclose.

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Schwartz, C., Vautrin, M. Phosphocalcium ceramics are efficient in the management of severe acetabular loss in revision hip arthroplasties. A 22 cases long-term follow-up study. Eur J Orthop Surg Traumatol 25, 227–232 (2015). https://doi.org/10.1007/s00590-014-1476-2

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