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International Orthopaedics

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01-01-2021 | Periprosthetic Fracture | Original Paper

Onlay fibula autografting technique and its comparison with cortical allograft for the reconstruction of periprosthetic bone defects around the femur

Authors: İbrahim Tuncay, Remzi Tözün, Orkhan Aliyev, Göksel Dikmen, Gökçer Uzer, Vahit Emre Özden, Fatih Yıldız

Published in: International Orthopaedics | Issue 1/2021

Abstract

Background

Bone defect around the femur related to revisions or periprosthetic fractures (PFF) is an issue. We present a bone defect reconstruction technique in femoral revisions and/or PFF using fibula autograft and compared our radiological and clinical results to that of allograft.

Methods

A total of 53 patients who underwent revision hip arthroplasty and/or PFF fixation with the use of cortical fibula autograft (FG group) or cortical allograft (CG group) were evaluated. After exclusions, 20 patients who had minimum two years of follow-up were investigated for each group, for their radiological and clinical outcomes.

Results

In FG and CG groups, the median ages were 69.5(44–90) and 62(38–88) years, follow-ups were 59(28–72) and 120(48–216) months, defect lengths were seven (1–10) and ten (1–17) cm, and grafts lengths were 16.5(10–30) and 20(12–37) cm, respectively. The rate of graft incorporation was 90% in each group and median time to incorporations were seven (4–12) and 12(6–24) months (p < 0.001), and graft resorption (moderate and severe) rates were 10% and 25% (p = 0.41), respectively. Median Harris Hip (77.6 vs 78.0), WOMAC (23.2 vs 22), SF-12 physical (50.0 vs 46.1), and SF-12 mental (53.8 vs 52.5) scores were similar between the groups, respectively. Kaplan–Meier survivorship analyses revealed an estimated mean survival of 100% at six years in FG group and 90% at 14 years in CG group.

Conclusion

In the reconstruction of periprosthetic bone defects after femoral revision or PPF, onlay cortical fibula autografts provide comparable clinical and radiological outcomes to allografts. Its incorporation is faster, it is cost-effective and easy to obtain without apparent morbidity.

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Title: Onlay fibula autografting technique and its comparison with cortical allograft for the reconstruction of periprosthetic bone defects around the femur
Authors: İbrahim Tuncay
Remzi Tözün
Orkhan Aliyev
Göksel Dikmen
Gökçer Uzer
Vahit Emre Özden
Fatih Yıldız
Publication date: 01-01-2021
Publisher: Springer Berlin Heidelberg
Keywords: Periprosthetic Fracture
Bone Defect
Published in: International Orthopaedics / Issue 1/2021
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-020-04876-4

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Onlay fibula autografting technique and its comparison with cortical allograft for the reconstruction of periprosthetic bone defects around the femur

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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