Preliminary experience with isoelastic total hip arthroplasty using impaction bone grafting

被引:0
作者
Nagi O.N. [1 ]
Dhillon M.S. [1 ]
Bapuraj J.R. [1 ]
Goni V.G. [1 ]
机构
[1] Dept. of Orthoped. Surg. and Radiol., P.G.I.M.E.R., Chandigarh
关键词
Allograft; Bone grafting; Bone paste; Isoelastic hip;
D O I
10.1007/BF02803170
中图分类号
学科分类号
摘要
Isoelastic THA using an uncemented acetabular cup fixed with pegs and screws along with a femoral stem containing a core of metal inside polyacetyl resin was used in 51 hips with an average follow up of 4 years 10 months. All cases were immobilized in abduction for 6 weeks post operative with deferred full weight bearing for another 6 weeks. One case failed due to deep infection, and one had extra medullary placement of the distal prosthesis. All others had improvement in the pain and function score; 2 patients were unsatisfied with the result. Excessive femoral reaming was avoided as we preferred to leave behind the 'living' cancellous bone to promote ingrowth along the prosthesis. This procedure may be a good alternative in young adults where cemented THA is not the procedure of choice. We attribute the good short term results in this series to the rigid post operative immobilisation (which we have labelled as the 'critical period'), filling up of the medullary canal with our technique of bone graft paste prior to prosthesis insertion, and leaving behind the endosteal cancellous bone inside the medullary cavity which possibly hastens bony incorporation of the femoral stem. A unique point in this study was our attempt to study bone formation around the prosthesis by axial CT scans, the results of which are discussed.
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页码:27 / 33
页数:6
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  • [1] Andrew T.A., Flanagan J.P., Gerundini H., Bombelli R., The Isoelastic, noncemented total hip arthroplasty. Preliminary experience with 400 cases, Clin Orthop, 206, pp. 127-138, (1986)
  • [2] Bombelli B., Mathys R., Cementless RM Isoelastic total hip prosthesis, J R Soc Med, 75, pp. 588-597, (1989)
  • [3] Decker S., The special problem of the replacement operation in cement -free prosthesis, Langenbecks Arch Chir, 372, pp. 477-480, (1987)
  • [4] Gerundini M., Fusco U., Avai A., Maistrell G., Cementless RM Isoelastic total hip prosthesis in revision surgery for loose prosthesis, J Orthop Traumatol, 13, 2, pp. 159-165, (1987)
  • [5] Gie G.A., Linder L., Rsm L., Simon J.P., Sloof T.J.J.H., Timperley A.J., Impacted cancellous allografts and cement for revision total hip arthroplasty, J Bone Joint Surg, 6-75, 1, pp. 14-21, (1993)
  • [6] Heitmyer U., Hierbolzer G., Haines J., The importance of Trochanteric lag screw to achieve primary stability in cementless fixation of the RM hip prothesis, Arch Orthop Trauma Surg, 106, pp. 120-122, (1987)
  • [7] Horne G., Berry N., Collis D., Isoelastic uncemented hip arthroplasty - Early experience, Aust NZ J Surg, 57, pp. 461-466, (1987)
  • [8] Jakim I., Barlin C., Sweet M.B., Isoelastic total hip arthroplalsty. a review of 34 cases, J Arthroplasty, 3, 3, pp. 191-199, (1988)
  • [9] Mathys R., Claes L. Jr., Mathys R. Sr., Strain distribution in the proximal femur after cementless implantation of hip replacments, Biomechanics Current Inter Disciplinary Research, pp. 371-376, (1985)
  • [10] Matricali G.A., Thibaut H., Hendrickx M., Thiabaut R., Revision of total hip arthroplasty using the RM isoelastic prosthesis, Acta Orthop, Belg, 59, 1 SUPPL., pp. 374-376, (1993)