Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
Journal of Orthopaedic Surgery and Research
Published in: Journal of Orthopaedic Surgery and Research 1/2015

Open Access 01-12-2015 | Research article

The use of morselized allografts without impaction and cemented cage support in acetabular revision surgery: a 4- to 9-year follow-up

Authors: Huifeng Ding, Yuanqing Mao, Bin Yu, Zhenan Zhu, Huiwu Li, Baoqing Yu, Jianming Huang

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2015

Login to get access

Abstract

Background

Acetabular revision arthroplasty with major bone loss is one of the most difficult operations in orthopedic surgery. The goal of the study was to evaluate midterm clinical results of the use of morselized allografts with cemented cage support in revision total hip replacement.

Methods

We identified 28 patients (29 hips) at an average follow-up of 73 months. Harris Hip Scores (HHS) were assessed before and after surgery. Pre- and postoperative radiographs were evaluated for restoration of the center of rotation, component migration, and graft incorporation.

Results and discussion

At follow-up, the mean HHS improved from 34 (range, 20–45) to 80 (range, 71–98) points. None of the components had been re-revised. On average, the revised hip center of rotation was improved significantly. Incorporation of the graft was complete in 23 hips. The midterm result of cage reconstruction with morselized bone allograft is relatively better than other studies using a similar cage construction. We believe we have three special modifications of this reconstruction technique that are beneficial for bone incorporation.

Conclusions

These data confirm that acetabular reconstruction using morselized allografts and cemented acetabular cages is effective in the midterm as a treatment for acetabular loosening with massive bone deficiency.
Literature
1.
Berry DJ, Muller ME. Revision arthroplasty using an anti-protrusio cage for massive acetabular bone deficiency. J Bone Joint Surg (Br). 1992;74:711–5.
2.
Gill TJ, Sledge JB, Muller ME. The Burch-Schneider anti-protrusio cage in revision total hip arthroplasty: indications, principles and long-term results. J Bone Joint Surg (Br). 1998;80:946–53.CrossRef
3.
Winter E, Piert M, Volkmann R, Maurer F, Eingartner C, Weise K, et al. Allogeneic cancellous bone graft and a Burch-Schneider ring for acetabular reconstruction in revision hip arthroplasty. J Bone Joint Surg Am. 2001;83-A:862–7.PubMed
4.
Duffy GP, O’Connor MI, Brodersen MP. Fatigue failure of the GAP ring. J Arthroplasty. 2007;22:711–4.CrossRefPubMed
5.
Buttaro MA, de la Rosa DM, Comba F, Piccaluga F. High failure rate with the GAP II ring and impacted allograft bone in severe acetabular defects. Clin Orthop Relat Res. 2012;470:3148–55.CrossRefPubMedCentralPubMed
6.
Böhm P, Banzhaf S. Acetabular revision with allograft bone. 103 revisions with 3 reconstruction alternatives, followed for 0.3–13 years. Acta Orthop Scand. 1999;70:240–9.CrossRefPubMed
7.
8.
Sun C, Lian YY, Jin YH, Zhao CB, Pan SQ, Liu XF. Clinical and radiographic assessment of cementless acetabular revision with morsellised allografts. Int Orthop. 2009;33:1525–30.CrossRefPubMedCentralPubMed
9.
Paprosky WG, Perona PG, Lawrence JM. Acetabular defect classification and surgical reconstruction in revision arthroplasty. A 6-year follow-up evaluation. J Arthroplasty. 1994;9:33–44.CrossRefPubMed
10.
Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969;51:737–55.PubMed
11.
Peters CL, Curtain M, Samuelson KM. Acetabular revision with the Burch-Schnieder antiprotrusio cage and cancellous allograft bone. J Arthroplasty. 1995;10:307–12.CrossRefPubMed
12.
DeLee JG, Charnley J. Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res. 1976;121:20–32.PubMed
13.
Gill TJ, Sledge JB, Muller ME. The management of severe acetabular bone loss using structural allograft and acetabular reinforcement devices. J Arthroplast. 2000;15:1–7.CrossRef
14.
van der Linde M, Tonino A. Acetabular revision with impacted grafting and a reinforcement ring: 42 patients followed for a mean of 10 years. Acta Orthop Scand. 2001;72:221–7.CrossRefPubMed
15.
Zehntner MK, Ganz R. Midterm results (5.5–10 years) of acetabular allograft reconstruction with the acetabular reinforcement ring during total hip revision. J Arthroplasty. 1994;9:469–79.CrossRefPubMed
16.
Udomkiat P, Dorr LD, Won YY, Longjohn D, Wan Z. Technical factors for success with metal ring acetabular reconstruction. J Arthroplasty. 2001;16:961–9.CrossRefPubMed
17.
Kim KC, Ha YC, Kang BJ, Lee YK, Ji HM, Koo KH. Use of cementless acetabular component with a hook and iliac flanges in revision arthroplasty for massive acetabular defect. J Orthop Sci. 2012;17:18–24.CrossRefPubMed
18.
Goldberg VM, Stevenson S. The biology of bone grafts. Semin Arthroplasty. 1993;4:58–63.PubMed
19.
Tägil M, Aspenberg P. Impaction of cancellous bone grafts impairs osteoconduction in titanium chambers. Clin Orthop Relat Res. 1998;352:231–8.PubMed
20.
Shih CH, Chen CH, Tsai MF, Tzen KY. Incorporation of allograft for acetabular reconstruction. Single photon emission CT in 21 hip arthroplasties followed for 2.5–5 years. Acta Orthop Scand. 1994;65:589–94.CrossRefPubMed
21.
Mall NA, Nunley RM, Smith KE, Maloney WJ, Clohisy JC, Barrack RL. The fate of grafting acetabular defects during revision total hip arthroplasty. Clin Orthop Relat Res. 2010;468:3286–94.CrossRefPubMedCentralPubMed
22.
Heekin RD, Engh CA, Vinh T. Morselized allograft in acetabular reconstruction. A postmortem retrieval analysis. Clin Orthop Relat Res. 1995;319:184–90.PubMed
23.
Tägil M, Aspenberg P. Fibrous tissue armoring increases the mechanical strength of an impacted bone graft. Acta Orthop Scand. 2001;72:78–82.CrossRefPubMed
24.
Buttaro MA, Comba F, Pusso R, Piccaluga F. Acetabular revision with metal mesh, impaction bone grafting, and a cemented cup. Clin Orthop Relat Res. 2008;466:2482–90.CrossRefPubMedCentralPubMed
25.
Lunn JV, Kearns SS, Quinlan W, Murray P, Byrne JO. Impaction allografting and the Kerboull acetabular reinforcement device: 35 hips followed for 3–7 years. Acta Orthop. 2005;76:296–302.PubMed
26.
Schreurs BW, Slooff TJ, Gardeniers JW, Buma P. Acetabular reconstruction with bone impaction grafting and a cemented cup: 20 years’ experience. Clin Orthop Relat Res. 2001;393:202–15.CrossRefPubMed
27.
Nivbrant B, Karrholm J. Migration and wear of hydroxyapatite-coated press-fit cups in revision hip arthroplasty: a radiostereometric study. J Arthroplasty. 1997;12:904–12.CrossRefPubMed
28.
Gie GA, Linder L, Ling RS, Simon JP, Slooff TJ, Timperley AJ. Impacted cancellous allografts and cement for revision total hip arthroplasty. J Bone Joint Surg (Br). 1993;75:14–21.
Metadata
Title
The use of morselized allografts without impaction and cemented cage support in acetabular revision surgery: a 4- to 9-year follow-up
Authors
Huifeng Ding
Yuanqing Mao
Bin Yu
Zhenan Zhu
Huiwu Li
Baoqing Yu
Jianming Huang
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2015
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-015-0222-8

Other articles of this Issue 1/2015

Journal of Orthopaedic Surgery and Research 1/2015 Go to the issue

Technical Note

Lever reduction using polyaxial screw and rod fixation system for the treatment of degenerative lumbar spondylolisthesis with spinal stenosis: technique and clinical outcome

Research article

Blood loss in primary total knee arthroplasty—body temperature is not a significant risk factor—a prospective, consecutive, observational cohort study

Research

Low magnitude of tensile stress represses the inflammatory response at intervertebral disc in rats

Research article

Prolonged resuscitation of metabolic acidosis after trauma is associated with more complications

Research article

Comparison of clinical and radiologic treatment outcomes of Kienböck’s disease

Research article

The use of clamped drainage to reduce blood loss in total hip arthroplasty