Document Detail


The survival and fate of acetabular reconstruction with impaction grafting for large defects.
MedLine Citation:
PMID:  20499294     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Impaction bone grafting has been used for acetabular reconstruction in revision surgery. However, most series do not establish differences in survival in revisions with differing severity of bone loss.
QUESTIONS/PURPOSES: We therefore determined (1) the survival rate for rerevision associated with varying degrees of bone loss; (2) the frequency with which bone graft resorption occurred; and (3) whether the reconstruction restored the anatomic center of rotation of the hip.
METHODS: We retrospectively reviewed 165 patients (181 hips) who underwent rerevision for major bone loss. Using the classification of Paprosky et al. 98 hips had a Grade 3A defect and 83 a Grade 3B. We determined survival rates for revision and graft resorption. Cup position was determined measuring vertical and horizontal positions and the distance from the center of the prosthetic femoral head to the normal center of rotation of the hip in both groups according to Ranawat. The minimum followup until rerevision or the latest evaluation was 0.3 years months (mean, 7.5 years; range, 0.3-17.7 years).
RESULTS: The survival rate for revision at 8 years was 84% (95% confidence interval: 61-100) for Grade 3A and 82% (95% confidence interval: 68-100) for Grade 3B. Twelve hips were rerevised. Seventeen grafts showed bone resorption. Acetabular cup position was anatomically restored in both Grades 3A and 3B.
CONCLUSIONS: The midterm results for impacted bone allograft and cemented all-polyethylene cups were similar in both Grade 3A and Grade 3B hips. Acetabular reconstruction allows anatomic positioning of the cups and is associated with a low rate of rerevision.
Authors:
Eduardo Garcia-Cimbrelo; Ana Cruz-Pardos; Eduardo Garcia-Rey; José Ortega-Chamarro
Related Documents :
15213504 - The modified ilioinguinal approach.
18534434 - Removal of the well-fixed hip resurfacing acetabular component: a simple, bone preservi...
11484124 - Severe pelvic pain and extrinsic compression of the rectum: late complication of total ...
1516304 - Evaluation of the learning curve associated with uncemented primary porous-coated anato...
19876884 - Osteolysis of the greater trochanter following reattachment of hip abductors using poly...
12865234 - Swan-shaped bone fixation device made of ni-ti shape memory alloy for treating humeral ...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  468     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-08     Completed Date:  2010-12-06     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3304-13     Citation Subset:  AIM; IM    
Affiliation:
Hospital La Paz, Madrid, Spain. gcimbrelo@yahoo.es
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Acetabulum / radiography,  surgery*
Adult
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip* / adverse effects,  instrumentation
Bone Cements / therapeutic use
Bone Resorption / etiology
Bone Transplantation* / adverse effects
Female
Graft Survival*
Hip Joint / physiopathology,  radiography,  surgery*
Hip Prosthesis
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Prosthesis Design
Range of Motion, Articular
Recovery of Function
Reoperation
Retrospective Studies
Spain
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Bone Cements
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Clinicopathologic prognostic factors of pure myxoid liposarcoma of the extremities and trunk wall.
Next Document:  The survivorship of protrusio cages for metastatic disease involving the acetabulum.