Skip to main content
Erschienen in: International Orthopaedics 3/2009

01.06.2009 | Original Article

Acetabular revision surgery with impacted bone allografts and cemented cups in patients younger than 55 years

verfasst von: Fernando Comba, Martín Buttaro, Rodolfo Pusso, Francisco Piccaluga

Erschienen in: International Orthopaedics | Ausgabe 3/2009

Einloggen, um Zugang zu erhalten

Abstract

This article summarises a clinical and radiographical analysis of 30 acetabular revisions in patients younger than 55 years old, performed with impaction bone grafting and cemented cups. Preoperative Merle D’Aubigne and Postel functional score was an average 7 points. At a mean follow-up of 86.5 months (range 34–228) functional score averaged 16.3 points. Radiolucent lines with no clinical impact were observed in 7% of DeLee and Charnley acetabular zones evaluated. Massive radiological migration, consistent with clinical failure, was observed in two cups. Three patients underwent re-revision surgery (10%): two due to infection and one due to mechanical failure. Reconstruction survival rate was 89% (CI 95% 71.9–96.4) overall, and 96% (CI 95% 82.6–99.3) ruling out cases of infection. Impacted bone allograft constitutes one of the reconstructive techniques of choice in acetabular revision surgery of young patients. Restoration of bone stock is essential in this group of patients due to the possibility of future revisions.
Literatur
1.
Zurück zum Zitat Bolder SB, Schreurs BW, Verdonschot N, van Unen JM, Gardeniers JW, Slooff TJ (2003) Particle size of bone graft and method of impaction affect initial stability of cemented cups: human cadaveric and synthetic pelvic specimen studies. Acta Orthop Scand 74:652–657PubMedCrossRef Bolder SB, Schreurs BW, Verdonschot N, van Unen JM, Gardeniers JW, Slooff TJ (2003) Particle size of bone graft and method of impaction affect initial stability of cemented cups: human cadaveric and synthetic pelvic specimen studies. Acta Orthop Scand 74:652–657PubMedCrossRef
2.
Zurück zum Zitat Comba F, Buttaro M, Pusso R, Piccaluga F (2006) Acetabular reconstruction with impacted bone allografts and cemented acetabular components: a 2- to 13-year follow-up study of 142 aseptic revisions. J Bone Joint Surg Br 88:865–869PubMedCrossRef Comba F, Buttaro M, Pusso R, Piccaluga F (2006) Acetabular reconstruction with impacted bone allografts and cemented acetabular components: a 2- to 13-year follow-up study of 142 aseptic revisions. J Bone Joint Surg Br 88:865–869PubMedCrossRef
3.
Zurück zum Zitat Crowther JD, Lachiewicz PF (2002) Survival and polyethylene wear of porous-coated acetabular components in patients less than fifty years old: results at nine to fourteen years. J Bone Joint Surg Am 84-A:729–735PubMed Crowther JD, Lachiewicz PF (2002) Survival and polyethylene wear of porous-coated acetabular components in patients less than fifty years old: results at nine to fourteen years. J Bone Joint Surg Am 84-A:729–735PubMed
4.
Zurück zum Zitat 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:126–137 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:126–137
5.
Zurück zum Zitat D’Aubigne RM, Postel M (1954) Functional results of hip arthroplasty with acrylic prosthesis. J Bone Joint Surg Am 36-A:451–475PubMed D’Aubigne RM, Postel M (1954) Functional results of hip arthroplasty with acrylic prosthesis. J Bone Joint Surg Am 36-A:451–475PubMed
6.
Zurück zum Zitat Dearborn JT, Harris WH (2000) Acetabular revision after failed total hip arthroplasty in patients with congenital hip dislocation and dysplasia. Results after a mean of 8.6 years. J Bone Joint Surg Am 82-A:1146–1153PubMed Dearborn JT, Harris WH (2000) Acetabular revision after failed total hip arthroplasty in patients with congenital hip dislocation and dysplasia. Results after a mean of 8.6 years. J Bone Joint Surg Am 82-A:1146–1153PubMed
7.
Zurück zum Zitat DeLee JG, Charnley J (1976) Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res:20–32 DeLee JG, Charnley J (1976) Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res:20–32
8.
Zurück zum Zitat Della Valle CJ, Berger RA, Rosenberg AG, Galante JO (2004) Cementless acetabular reconstruction in revision total hip arthroplasty. Clin Orthop Relat Res:96–100 Della Valle CJ, Berger RA, Rosenberg AG, Galante JO (2004) Cementless acetabular reconstruction in revision total hip arthroplasty. Clin Orthop Relat Res:96–100
9.
Zurück zum Zitat Garbuz D, Morsi E, Mohamed N, Gross AE (1996) Classification and reconstruction in revision acetabular arthroplasty with bone stock deficiency. Clin Orthop Relat Res:98–107 Garbuz D, Morsi E, Mohamed N, Gross AE (1996) Classification and reconstruction in revision acetabular arthroplasty with bone stock deficiency. Clin Orthop Relat Res:98–107
10.
Zurück zum Zitat Mowe JC (1988) Standards for tissue banking. American Association of Tissue Banks, Arlington, Virginia, USA Mowe JC (1988) Standards for tissue banking. American Association of Tissue Banks, Arlington, Virginia, USA
11.
Zurück zum Zitat Nunez LV, Buttaro MA, Morandi A, Pusso R, Piccaluga F (2007) Frozen sections of samples taken intraoperatively for diagnosis of infection in revision hip surgery. Acta Orthop 78:226–230PubMedCrossRef Nunez LV, Buttaro MA, Morandi A, Pusso R, Piccaluga F (2007) Frozen sections of samples taken intraoperatively for diagnosis of infection in revision hip surgery. Acta Orthop 78:226–230PubMedCrossRef
12.
Zurück zum Zitat Oakes DA, Cabanela ME (2006) Impaction bone grafting for revision hip arthroplasty: biology and clinical applications. J Am Acad Orthop Surg 14:620–628PubMed Oakes DA, Cabanela ME (2006) Impaction bone grafting for revision hip arthroplasty: biology and clinical applications. J Am Acad Orthop Surg 14:620–628PubMed
13.
Zurück zum Zitat Ornstein E, Franzen H, Johnsson R, Sandquist P, Stefansdottir A, Sundberg M (1999) Migration of the acetabular component after revision with impacted morselized allografts: a radiostereometric 2-year follow-up analysis of 21 cases. Acta Orthop Scand 70:338–342PubMedCrossRef Ornstein E, Franzen H, Johnsson R, Sandquist P, Stefansdottir A, Sundberg M (1999) Migration of the acetabular component after revision with impacted morselized allografts: a radiostereometric 2-year follow-up analysis of 21 cases. Acta Orthop Scand 70:338–342PubMedCrossRef
14.
Zurück zum Zitat Schimmel JW, Buma P, Versleyen D, Huiskes R, Slooff TJ (1998) Acetabular reconstruction with impacted morselized cancellous allografts in cemented hip arthroplasty: a histological and biomechanical study on the goat. J Arthroplasty 13:438–448PubMedCrossRef Schimmel JW, Buma P, Versleyen D, Huiskes R, Slooff TJ (1998) Acetabular reconstruction with impacted morselized cancellous allografts in cemented hip arthroplasty: a histological and biomechanical study on the goat. J Arthroplasty 13:438–448PubMedCrossRef
15.
Zurück zum Zitat Schreurs BW, Bolder SB, Gardeniers JW, Verdonschot N, Slooff TJ, Veth RP (2004) Acetabular revision with impacted morsellised cancellous bone grafting and a cemented cup. A 15- to 20-year follow-up. J Bone Joint Surg Br 86:492–497PubMed Schreurs BW, Bolder SB, Gardeniers JW, Verdonschot N, Slooff TJ, Veth RP (2004) Acetabular revision with impacted morsellised cancellous bone grafting and a cemented cup. A 15- to 20-year follow-up. J Bone Joint Surg Br 86:492–497PubMed
16.
Zurück zum Zitat 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:2385–2392PubMed 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:2385–2392PubMed
17.
Zurück zum Zitat Schreurs BW, Slooff TJ, Buma P, Gardeniers JW, Huiskes R (1998) Acetabular reconstruction with impacted morsellised cancellous bone graft and cement. A 10- to 15-year follow-up of 60 revision arthroplasties. J Bone Joint Surg Br 80:391–395PubMedCrossRef Schreurs BW, Slooff TJ, Buma P, Gardeniers JW, Huiskes R (1998) Acetabular reconstruction with impacted morsellised cancellous bone graft and cement. A 10- to 15-year follow-up of 60 revision arthroplasties. J Bone Joint Surg Br 80:391–395PubMedCrossRef
18.
Zurück zum Zitat Schreurs BW, Slooff TJ, Gardeniers JW, Buma P (2001) Acetabular reconstruction with bone impaction grafting and a cemented cup: 20 years’ experience. Clin Orthop Relat Res:202–215 Schreurs BW, Slooff TJ, Gardeniers JW, Buma P (2001) Acetabular reconstruction with bone impaction grafting and a cemented cup: 20 years’ experience. Clin Orthop Relat Res:202–215
19.
Zurück zum Zitat Schreurs BW, van Tienen TG, Buma P, Verdonschot N, Gardeniers JW, Slooff TJ (2001) Favorable results of acetabular reconstruction with impacted morsellized bone grafts in patients younger than 50 years: a 10- to 18-year follow-up study of 34 cemented total hip arthroplasties. Acta Orthop Scand 72:120–126PubMedCrossRef Schreurs BW, van Tienen TG, Buma P, Verdonschot N, Gardeniers JW, Slooff TJ (2001) Favorable results of acetabular reconstruction with impacted morsellized bone grafts in patients younger than 50 years: a 10- to 18-year follow-up study of 34 cemented total hip arthroplasties. Acta Orthop Scand 72:120–126PubMedCrossRef
20.
Zurück zum Zitat Silverton CD, Rosenberg AG, Sheinkop MB, Kull LR, Galante JO (1996) Revision of the acetabular component without cement after total hip arthroplasty. A follow-up note regarding results at seven to eleven years. J Bone Joint Surg Am 78:1366–1370PubMed Silverton CD, Rosenberg AG, Sheinkop MB, Kull LR, Galante JO (1996) Revision of the acetabular component without cement after total hip arthroplasty. A follow-up note regarding results at seven to eleven years. J Bone Joint Surg Am 78:1366–1370PubMed
21.
Zurück zum Zitat Slooff TJ, Schimmel JW, Buma P (1993) Cemented fixation with bone grafts. Orthop Clin North Am 24:667–677PubMed Slooff TJ, Schimmel JW, Buma P (1993) Cemented fixation with bone grafts. Orthop Clin North Am 24:667–677PubMed
22.
Zurück zum Zitat Smith SE, Estok DM, 2nd, Harris WH (2000) 20-year experience with cemented primary and conversion total hip arthroplasty using so-called second-generation cementing techniques in patients aged 50 years or younger. J Arthroplasty 15:263–273PubMedCrossRef Smith SE, Estok DM, 2nd, Harris WH (2000) 20-year experience with cemented primary and conversion total hip arthroplasty using so-called second-generation cementing techniques in patients aged 50 years or younger. J Arthroplasty 15:263–273PubMedCrossRef
23.
Zurück zum Zitat Stromberg CN, Herberts P (1996) Cemented revision total hip arthroplasties in patients younger than 55 years old. A multicenter evaluation of second-generation cementing technique. J Arthroplasty 11:489–499PubMedCrossRef Stromberg CN, Herberts P (1996) Cemented revision total hip arthroplasties in patients younger than 55 years old. A multicenter evaluation of second-generation cementing technique. J Arthroplasty 11:489–499PubMedCrossRef
24.
Zurück zum Zitat Toms AD, Barker RL, Jones RS, Kuiper JH (2004) Impaction bone-grafting in revision joint replacement surgery. J Bone Joint Surg Am 86-A:2050–2060PubMed Toms AD, Barker RL, Jones RS, Kuiper JH (2004) Impaction bone-grafting in revision joint replacement surgery. J Bone Joint Surg Am 86-A:2050–2060PubMed
25.
Zurück zum Zitat Vargas B, Caton J (2007) Acetabular revision with freeze-dried irradiated and chemically treated allograft: a minimum 5-year follow-up of 17 cases. Int Orthop (in press) Vargas B, Caton J (2007) Acetabular revision with freeze-dried irradiated and chemically treated allograft: a minimum 5-year follow-up of 17 cases. Int Orthop (in press)
Metadaten
Titel
Acetabular revision surgery with impacted bone allografts and cemented cups in patients younger than 55 years
verfasst von
Fernando Comba
Martín Buttaro
Rodolfo Pusso
Francisco Piccaluga
Publikationsdatum
01.06.2009
Verlag
Springer-Verlag
Erschienen in
International Orthopaedics / Ausgabe 3/2009
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-007-0503-x

Weitere Artikel der Ausgabe 3/2009

International Orthopaedics 3/2009 Zur Ausgabe

Letter to the Editor

Letter to the editor

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Knie-TEP: Kein Vorteil durch antibiotikahaltigen Knochenzement

29.05.2024 Periprothetische Infektionen Nachrichten

Zur Zementierung einer Knie-TEP wird in Deutschland zu über 98% Knochenzement verwendet, der mit einem Antibiotikum beladen ist. Ob er wirklich besser ist als Zement ohne Antibiotikum, kann laut Registerdaten bezweifelt werden.

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

28.05.2024 Häusliche Gewalt Nachrichten

In der Notaufnahme wird die Chance, Opfer von häuslicher Gewalt zu identifizieren, von Orthopäden und Orthopädinnen offenbar zu wenig genutzt. Darauf deuten die Ergebnisse einer Fragebogenstudie an der Sahlgrenska-Universität in Schweden hin.

Fehlerkultur in der Medizin – Offenheit zählt!

28.05.2024 Fehlerkultur Podcast

Darüber reden und aus Fehlern lernen, sollte das Motto in der Medizin lauten. Und zwar nicht nur im Sinne der Patientensicherheit. Eine negative Fehlerkultur kann auch die Behandelnden ernsthaft krank machen, warnt Prof. Dr. Reinhard Strametz. Ein Plädoyer und ein Leitfaden für den offenen Umgang mit kritischen Ereignissen in Medizin und Pflege.

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.