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Clinical and radiographic assessment of cementless acetabular revision with morsellised allografts

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Abstract

The aim of this study was to evaluate the clinical and radiographic results of cementless acetabular revision with deep frozen morsellised allografts. Sixty-one patients (65 hips) underwent acetabular revision using cementless components and deep frozen morsellised allografts. Fifty-seven hips (53 patients) were reviewed at a mean of 105.1 months (range 72–180 months) after revision. The study group included 29 males and 24 females with a mean age of 46.4 years. One cup underwent further revision for aseptic loosening and two were defined as radiographic failures. The mean time for allograft incorporation was 12.5 months (range 6–24 months) after index surgery. The mean Harris hip score of the patients improved from 61.1 points preoperatively to 91.6 points postoperatively. Linear and cavitary osteolysis was observed in two and 12 hips, respectively. The acetabular revision using cementless components with deep frozen morsellized allografts provides favourable clinical and radiographic results, although the initial disease and age may adversely affect the outcomes.

Résumé

L’objectif de cette étude est d’évaluer les résultats cliniques et radiographiques de la chirurgie de révision acétabulaire associant allogreffes morcelées, cryoconservées. Matériel et méthode : 61 patients (65 hanches) ont bénéficié d’une reprise avec cupule sans ciment et allogreffes morcelées cryoconservées. 57 hanches (53 patients) ont été revues en moyenne à 105,1 mois (de 72 à 180 mois) après la révision. Ce groupe comprend 29 hommes et 24 femmes avec un âge moyen de 46,4 ans. Résultats : une cupule a nécessité une nouvelle reprise pour un descellement aseptique et 2 ont été cataloguées comme échec sur le plan radiographique. Le temps moyen de l’incorporation de l’allogreffe a été de 12,5 mois (entre 6 et 24 mois), le score moyen de Harris de ces patients s’est amélioré de 61,1 points en préopératoire à 91,6 points en postopératoire. Des ostéolyses linéaires et cavitaires ont été observées respectivement sur 2 et 12 hanches. Conclusions : la technique de révision acétabulaire utilisant un composant non cimenté avec des greffes morcellées cryoconservées permet d’obtenir des résultats cliniques et radiographiques fiables néanmoins, la pathologie initiale et l’âge des patients peuvent avoir des effets négatifs sur l’évolution.

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References

  1. Callaghan JJ, Salvati EA, Pellicci PM et al (1985) Results of revision of mechanical failure after cemented total hip replacement, 1979 to 1982: a two to five year followup. J Bone Joint Surg AM 67:1074–1085

    PubMed  CAS  Google Scholar 

  2. Marti RK, Schuller HM, Besselaar PP et al (1990) Results of revision of hip arthroplasty with cement: a five to fourteen-year followup study. J Bone Joint Surg AM 72:346–354

    PubMed  CAS  Google Scholar 

  3. Hungerford DS, Jones LC (1988) The rationale of cementless revision of cemented arthroplasty failures. Clin Orthop Relat Res 235:12–24

    PubMed  Google Scholar 

  4. Etienne G, Bezwada HP, Hungerford DS et al (2004) The incorporation of morselized bone grafts in cementless acetabular revisions. Clin Orthop Relat Res 428:241–246

    Article  PubMed  Google Scholar 

  5. Lie SA, Havelin LI, Furnes ON et al (2004) Failure rates for 4762 revision total hip arthroplasties in the Norwegian Arthroplasty Register. J Bone Joint Surg Br 86:504–509

    PubMed  CAS  Google Scholar 

  6. Dearborn JT, Harris WH (2000) Acetabular revision arthroplasty using so-called jumbo cementless components: an average 7-year follow-up study. J Arthroplasty 15:8–15

    Article  PubMed  CAS  Google Scholar 

  7. Shinar AA, Harris WH (1997) Bulk structural autogenous grafts and allografts for reconstruction of the acetabulum in total hip arthroplasty. Sixteen-year-average follow-up. J Bone Joint Surg Am 79:159–168

    PubMed  CAS  Google Scholar 

  8. Dearborn JT, Harris WH (2000) Acetabular revision arthroplasty using so-called jumbo cementless components: an average 7-year follow-up study. J Arthroplasty 15:8–15

    Article  PubMed  CAS  Google Scholar 

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

    PubMed  Google Scholar 

  10. Fan CY, Chen WM, Lee OK et al (2008) Acetabular revision arthroplasty using jumbo cups: an experience in Asia. Arch Orthop Trauma Surg Aug 128(8):809–813

    Article  Google Scholar 

  11. Livermore J, Ilstrup D, Morrey B (1990) Effect of femoral head size on wear of polyethylene acetabular component. J Bone Joint Surg Am 72:518–528

    PubMed  CAS  Google Scholar 

  12. Wilson MG, Nikpoor N, Alibadi P et al (1989) The fate of acetabular allografts after bipolar revision arthroplasty of the hip. J Bone Joint Surg Am 71:1469–1479

    PubMed  CAS  Google Scholar 

  13. Conn RA, Paterson LFA, Stauffer RN et al (1985) Management of acetabular deficiency: long-term results of bone grafting the acetabulum in total hip arthroplasty. Orthop Trans 9:451–452

    Google Scholar 

  14. Moskal JT, Higgins ME, Shen J (2008) Type III acetabular defect revision with bilobed components: five-year results. Clin Orthop Relat Res 466(3):691–695

    Article  PubMed  Google Scholar 

  15. Civinini R, Capone A, Carulli C et al (2008) Acetabular revisions using a cementless oblong cup: five to ten year results. Int Orthop 32(2):189–193

    Article  PubMed  CAS  Google Scholar 

  16. Arts JJ, Verdonschot N, Buma P et al (2006) Larger bone graft size and washing of bone grafts prior to impaction enhance the initial stability of cemented cups: experiments using a synthetic acetabular model. Acta Orthop 77:227–233

    Article  PubMed  Google Scholar 

  17. Palm L, Jacobsson SA, Kvist J et al (2007) Acetabular revision with extensive allograft impaction and uncemented hydroxyapatite-coated implants. Results after 9 (7–11) years follow-up. J Arthroplasty 22(8):1083–1091

    Article  PubMed  Google Scholar 

  18. Oakley J, Kuiper JH (2006) Factors affecting the cohesion of impaction bone graft. J Bone Joint Surg Br 88:828–831

    Article  PubMed  CAS  Google Scholar 

  19. Dunlop DG, Brewster NT, Madabhushi SP et al (2003) Techniques to improve the shear strength of impacted bone graft: the effect of particle size and washing of the graft. J Bone Joint Surg Am 85:639–646

    PubMed  Google Scholar 

  20. Ullmark G (2000) Bigger size and defatting of bone chips will increase cup stability. Arch Orthop Trauma Surg 120:445–447

    Article  PubMed  CAS  Google Scholar 

  21. Van der Donk S, Weernink T, Buma P et al (2003) Rinsing morselized allografts improves bone and tissue ingrowth. Clin Orthop Relat Res 408:302–310

    Article  PubMed  Google Scholar 

  22. Sorensen J, Ullmark G, Langstrom B et al (2003) Rapid bone and blood flow formation in impacted morselized allografts: positron emission tomography (PET) studies on allografts in 5 femoral component revisions of total hip arthroplasty. Acta Orthop Scand 74:633–643

    Article  PubMed  Google Scholar 

  23. Ullmark G, Obrant KJ (2002) Histology of impacted bone-graft incorporation. J Arthroplasty 17:150–157

    Article  PubMed  CAS  Google Scholar 

  24. Paulsen A, Pedersen AB, Johnsen SP et al (2007) Effect of hydroxyapatite coating on risk of revision after primary total hip arthroplasty in younger patients: findings from the Danish Hip Arthroplasty Registry. Acta Orthop Oct 78(5):622–628

    Article  Google Scholar 

  25. Zhu YH, Chiu KY, Tang WM (2001) Polyethylene wear and osteolysis in total hip arthroplasty. J Orthop Sur 9:91–99

    Google Scholar 

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Fourth Affiliated Hospital of Harbin Medical University, No. 37, Yi yuan Street, Nan gang District, Harbin, Heilongjiang Province, 150001, China

    Chuang Sun, Yong-Yun Lian, Cheng-Bin Zhao, Shi-Qi Pan & Xue-Feng Liu

  2. Department of Orthopedic Surgery, Social Rehabilitation Hospital of Heilongjiang Province, No. 75, Nan zhi Road, Xiangfang District, Harbin, Heilongjiang Province, 150030, China

    Yu-Hua Jin

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  1. Chuang Sun
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  2. Yong-Yun Lian
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  3. Yu-Hua Jin
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  4. Cheng-Bin Zhao
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  5. Shi-Qi Pan
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  6. Xue-Feng Liu
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Correspondence to Yong-Yun Lian.

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Chung Sun and Yong-Yun Lian contributed equally to the manuscript.

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Sun, C., Lian, YY., Jin, YH. et al. Clinical and radiographic assessment of cementless acetabular revision with morsellised allografts. International Orthopaedics (SICOT) 33, 1525–1530 (2009). https://doi.org/10.1007/s00264-009-0722-4

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  • DOI: https://doi.org/10.1007/s00264-009-0722-4

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