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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

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Abstract

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 use of 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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Acknowledgments

We gratefully acknowledge Dr. Sung-Woo Choi and Professor Seung-Han Woo for their assistance with the present study. We also thank Dr. Timothy Barker for assistance in finalizing the manuscript, and Professor Ross Crowford for useful comments during the preparation of the manuscript.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, College of Medicine, University of Soonchunhyang, Bucheon Hospital, 1174 Jung-Dong Wonmi-Gu Bucheon-Si, Gyeonggi-Do, 420-767, South Korea

    Soo-Jae Yim & Min-Young Kim

  2. Department of Orthopedic Surgery, College of Medicine, University of Soonchunhyang, Seoul Hospital, Gyeonggi-Do, South Korea

    Yoo-Sung Suh

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  1. Soo-Jae Yim
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  2. Min-Young Kim
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  3. Yoo-Sung Suh
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Correspondence to Soo-Jae Yim.

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Yim, SJ., Kim, MY. & Suh, YS. 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. International Orthopaedics (SICOT) 31, 297–302 (2007). https://doi.org/10.1007/s00264-006-0201-0

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