Acetabular reconstruction using a composite layer of impacted cancellous allograft bone and cement: minimum 5-year follow-up study

被引:3
作者
Garala, Kanai [1 ]
Boutefnouchet, Tarek [2 ]
Amblawaner, Rishanthanan [3 ]
Lawrence, Trevor [4 ]
机构
[1] Univ Hosp Coventry & Warwickshire, Trauma & Orthopaed Dept, Coventry, W Midlands, England
[2] Birmingham Heartlands Hosp, Trauma & Orthopaed Dept, Birmingham, W Midlands, England
[3] Guys & St Thomas Hosp, Radiol Dept, London, England
[4] Solihull Hosp, Orthopaed Dept, Birmingham, W Midlands, England
关键词
Acetabular reconstruction; cemented acetabular fixation; clinical; impaction grafting; implant survival; radiological outcomes; total hip arthroplasty; TOTAL HIP-ARTHROPLASTY; REVISION; CUP; COMPONENT; CLASSIFICATION; REPLACEMENT; INFECTION; GRAFT;
D O I
10.1177/1120700020941407
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background: Revision total hip arthroplasty (rTHA) is often complex and has a less reliable outcome than primary total hip arthroplasty. Acetabular reconstruction remains a challenge because of the variable amount of bone loss. This study describes and evaluates a novel technique of acetabular reconstruction using composite bone grafting. Patients and methods: Between June 2005 and January 2012, 108 consecutive patients underwent revision hip arthroplasty in which the acetabular component was revised using composite bone grafting. Of these, 24 were lost to follow-up leaving 84 in the study with a minimum 5-year follow-up. There were 54 women and 30 men with a mean age of 70.1 (31-91) years. All patients were assessed clinically and radiologically after a minimum of 5 years. The primary outcome measures were rate of re-revision, patient-reported outcomes and radiological evidence of loosening. Results: The mean follow-up after revision surgery was 6.9 years (5-10). At operation, 60 patients had an acetabular defect of AAOS stage 3 or more. There was no evidence of loosening in 69 revision acetabular components; 12 showed evidence of non-progressive loosening and 3 patients underwent a re-revision procedure (2 for infection, 1 recurrent dislocation). The mean postoperative Hip Disability and Osteoarthritis Outcome Score (HOOS) was 89.11/100 (95% CI, 87.8-90.5). Scores were significantly improved in patients with a more extensive preoperative defect (p = 0.006). The overall patient satisfaction rate at final follow-up was very high. Conclusions: Composite impaction grafting using a layered cement and bone graft technique can give satisfactory clinical and radiological outcomes in the medium- to long-term.
引用
收藏
页码:197 / 204
页数:8
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