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01-09-2015 | Original Paper

The value of bulk femoral head allograft in acetabular reconstruction using Kerboull-type plate

Authors: Daisuke Inoue, Tamon Kabata, Toru Maeda, Yoshitomo Kajino, Takashi Yamamoto, Tomoharu Takagi, Takaaki Oomori, Hiroyuki Tsuchiya

Published in: International Orthopaedics | Issue 9/2015

Abstract

Purpose

This study investigated the mid- and long-term results of acetabular reconstruction using a KT plate with an allograft and showed the utility of filling the bony defect with bulk femoral head allograft rather than morselised allograft.

Methods

We retrospectively investigated a consecutive series of 31 hips in 30 patients who underwent primary THA or revision THA between March 2002 and March 2012. Bulk grafts from femoral head allografts were used in 16 hips and morselised grafts were used in 15 hips. The mean follow-up period was 7.2 years (3–13 years). The acetabular bone defects were classified according to the American Academy of Orthopedic Surgeons grading system. Type II defects were present in five hips; 26 hips were type III.

Results

Radiological failure, defined as absolute error of the inclination of the KT plate >3°, breakage of the KT plate or screw, and/or absolute error of the vertical or horizontal migration of the femoral head >3 mm was found in 12 cases. All these complications appeared in the morselized group; there were no complications in the bulk group. The eight-year survival rate of morselised grafts was 52.5 % and that of bulk grafts was 100 %, using radiological loosening as an end point.

Conclusions

We conclude that using bulk graft from femoral head allografts is necessary to achieve mechanically stable reconstruction for large acetabular bone defects.

Kosashvili Y, Backstein D, Safir O, Lakstein D, Gross AE (2011) Dislocation and infection after revision total hip arthroplasty: comparison between the first and multiply revised total hip arthroplasty. J Arthroplasty 26(8):1170–1175CrossRefPubMed

Tanaka C, Shikata J, Ikenaga M, Takahashi M (2003) Acetabular reconstruction using a Kerboull-type acetabular reinforcement device and hydroxyapatite granules: a 3- to 8-year follow-up study. J Arthroplasty 18(6):719–725CrossRefPubMed

Kawanabe K, Akiyama H, Onishi E, Nakamura T (2007) Revision total hip replacement using the Kerboull acetabular reinforcement device with morsellised or bulk graft: results at a mean follow-up of 8.7 years. J Bone Joint Surg (Br) 89(1):26–31CrossRef

Ito H, Tanino H, Yamanaka Y, Sato T, Minami A, Matsuno T (2010) Porous-coated cementless acetabular components without bulk bone graft in revision surgery. J Arthroplasty 25(8):1307–1310CrossRefPubMed

Schreurs BW, Busch VJ, Welten ML, Verdonschot N, Slooff TJ, Gardeniers JW (2004) Acetabular reconstruction with impaction bone-grafting and a cemented cup in patients younger than fifty years old. J Bone Joint Surg Am 86-A(11):2385–2392PubMed

Abolghasemian M, Tangsataporn S, Sternheim A, Backstein D, Safir O, Gross AE (2013) Combined trabecular metal acetabular shell and augment for acetabular revision with substantial bone loss: a mid-term review. Bone Joint J 95-B(2):166–172CrossRefPubMed

D’Antonio JA, Capello WN, Borden LS, Bargar WL, Bierbaum BF, Boettcher WG, Steinberg ME, Stulberg SD, Wedge JH (1989) Classification and management of acetabular abnormalities in total hip arthroplasty. Clin Orthop Relat Res 243:126–137PubMed

Shima Y (1971) Standard for evaluation osteoarthritis of the hip. J Jpn Orthop Assoc 45:813–833

Okano K, Miyata N, Enomoto H, Osaki M, Shindo H (2010) Revision with impacted bone allografts and the Kerboull cross plate for massive bone defect of the acetabulum. J Arthroplasty 25(4):594–599CrossRefPubMed

10.

Baba T, Shitoto K (2010) Revision of total hip arthroplasty using the Kerboull and KT plates. Int Orthop 34(3):341–347PubMedCentralCrossRefPubMed

11.

Kerboull M, Hamadouche M, Kerboull L (2000) The Kerboull acetabular reinforcement device in major acetabular reconstructions. Clin Orthop Relat Res 378:155–168CrossRefPubMed

12.

Garbuz D, Morsi E, Gross AE (1996) Revision of the acetabular component of a total hip arthroplasty with a massive structural allograft. Study with a minimum five-year follow-up. J Bone Joint Surg Am 78(5):693–697PubMed

13.

Lunn JV, Kearns SS, Quinlan W, Murray P, Byrne JO (2005) Impaction allografting and the Kerboull acetabular reinforcement device: 35 hips followed for 3–7 years. Acta Orthop 76(3):296–302PubMed

14.

Hori J, Yasunaga Y, Yamasaki T, Yoshida T, Oshima S, Yamasaki K, Matsuo T, Ochi M (2012) Mid-term results of acetabular reconstruction using a Kerboull-type acetabular reinforcement device. Int Orthop 36(1):23–26PubMedCentralCrossRefPubMed

15.

Zehntner MK, Ganz R (1994) Midterm results (5.5–10 years) of acetabular allograft reconstruction with the acetabular reinforcement ring during total hip revision. J Arthroplasty 9(5):469–479CrossRefPubMed

16.

Akiyama H, Yamamoto K, Tsukanaka M, Kawanabe K, Otsuka H, So K, Goto K, Nakamura T (2011) Revision total hip arthroplasty using a Kerboull-type acetabular reinforcement device with bone allograft: minimum 4.5-year follow-up results and mechanical analysis. J Bone Joint Surg (Br) 93(9):1194–1200CrossRef

17.

Kaku N, Hara K, Tabata T, Tsumura H (2014) Influence of the volume of bone defect, bone grafting methods, and hook fixation on stress on the Kerboull-type plate and screw in total hip arthroplasty: three-dimensional finite element analysis. Eur J Orthop Surg Traumatol 25(2):321–329CrossRefPubMed

18.

Tägil M (2000) The morselized and impacted bone graft. Animal experiments on proteins, impaction and load. Acta Orthop Scand Suppl 290:1–40PubMed

19.

Jasty M, Harris WH (1990) Salvage total hip reconstruction in patients with major acetabular bone deficiency using structural femoral head allografts. J Bone Joint Surg (Br) 72(1):63–67

20.

Kawanabe K, Akiyama H, Goto K, Maeno S, Nakamura T (2011) Load dispersion effects of acetabular reinforcement devices used in revision total hip arthroplasty: a simulation study using finite element analysis. J Arthroplasty 26(7):1061–1066CrossRefPubMed

Title: The value of bulk femoral head allograft in acetabular reconstruction using Kerboull-type plate
Authors: Daisuke Inoue
Tamon Kabata
Toru Maeda
Yoshitomo Kajino
Takashi Yamamoto
Tomoharu Takagi
Takaaki Oomori
Hiroyuki Tsuchiya
Publication date: 01-09-2015
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 9/2015
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-015-2857-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The value of bulk femoral head allograft in acetabular reconstruction using Kerboull-type plate

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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