Erschienen in:
01.12.2010 | Symposium: Papers Presented at the 2009 Closed Meeting of the International Hip Society
Long-term Results for Minor Column Allografts in Revision Hip Arthroplasty
verfasst von:
Paul T. H. Lee, MB BCh, FRCS (Eng), FRCS (Orth), Guy Raz, MD, Oleg A. Safir, MD, MED, FRCSC, David J. Backstein, MD, MED, FRCSC, Allan E. Gross, MD, FRCSC, OOnt
Erschienen in:
Clinical Orthopaedics and Related Research®
|
Ausgabe 12/2010
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Abstract
Background
While acetabular structural allografts provide an important alternative for reconstructions, concerns remain with long-term graft resorption, collapse, and failure. Midterm studies of minor column (shelf) allograft suggest reasonable survival but long-term survival is unknown.
Questions/purposes
We therefore assessed long-term graft/cup survivorship, functional scores, radiographic resorption, and complications associated with minor column allograft.
Methods
We retrospectively reviewed 74 patients (85 hips) with a mean age of 54 years (range, 28–83 years) undergoing acetabular cup revision using a minor column allograft. A minor column allograft was used in uncontained acetabular bone defects sized between 30% and 50% of the acetabulum. Graft failure was considered to occur when the graft required revision with another graft, metal augment, reconstruction cage, or excision arthroplasty. The minimum followup was 5 years (mean, 16 years; range, 5.3–25 years).
Results
Twenty-three patients (27 hips) had rerevision for all causes at a mean time to rerevision of 6.9 years (range, 0.1–23). Fifteen grafts failed at a mean time-to-rerevision of 6.1 years (range, 0.5–23.2). The 15- and 20-year Kaplan-Meier survivorships were 61% and 55% for cups and 78% for grafts with rerevision for all causes as end point. With rerevision for aseptic loosening as end point, survivorships were 67% and 61% for cups and 81% for grafts. The mean modified Harris hip scores were 41 (range, 20–60) preoperatively, 73 (range, 40–95) at 1 year postoperatively and 73 (range, 26–93) at last followup.
Conclusion
The data may provide a long-term benchmark by which future treatments for Type III defects can be measured.
Level of Evidence
Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.