Document Detail

The survival and fate of acetabular reconstruction with impaction grafting for large defects.
MedLine Citation:
PMID:  20499294     Owner:  NLM     Status:  MEDLINE    
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.
Eduardo Garcia-Cimbrelo; Ana Cruz-Pardos; Eduardo Garcia-Rey; José Ortega-Chamarro
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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    
Hospital La Paz, Madrid, Spain.
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MeSH Terms
Acetabulum / radiography,  surgery*
Aged, 80 and over
Arthroplasty, Replacement, Hip* / adverse effects,  instrumentation
Bone Cements / therapeutic use
Bone Resorption / etiology
Bone Transplantation* / adverse effects
Graft Survival*
Hip Joint / physiopathology,  radiography,  surgery*
Hip Prosthesis
Kaplan-Meier Estimate
Middle Aged
Prosthesis Design
Range of Motion, Articular
Recovery of Function
Retrospective Studies
Time Factors
Treatment Outcome
Reg. No./Substance:
0/Bone Cements

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