scholarly journals Incorporation and Remodeling of Structural Allografts in Acetabular Reconstruction

2018 ◽  
Vol 100 (16) ◽  
pp. 1406-1415 ◽  
Author(s):  
Sebastian Butscheidt ◽  
Menard Moritz ◽  
Thorsten Gehrke ◽  
Klaus Püschel ◽  
Michael Amling ◽  
...  
Keyword(s):  
Acetabular Reconstruction ◽  
Structural Allografts

scholarly journals The use of a non-biological, bridging, antiprotrusio cage in complex revision hip arthroplasty and periacetabular reconstructive oncologic surgery. Is still today a valid option?: A mid/long-term survival and complications’ analysis

2021 ◽  
Author(s):  
Matteo Innocenti ◽  
Francesco Muratori ◽  
Giacomo Mazzei ◽  
Davide Guido ◽  
Filippo Frenos ◽  
...  
Keyword(s):  
Proximal Femur ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards Model ◽  
Harris Hip Score ◽  
Acetabular Reconstruction ◽  
Reconstruction Method ◽  
Term Survival ◽  
Primary Tumors ◽  
Risk Of Death ◽  
Group B

Abstract Introduction Burch–Schneider-like antiprotrusio cages (B-SlAC) still remain helpful implants to bridge severe periacetabular bone losses. The purpose of this study was to evaluate outcomes and estimate both cages’ failures and complication risks in a series of B-SlAC implanted in revision of failed total hip arthroplasties (THA) or after resection of periacetabular primary or secondary bone malignancies. Risk factors enhancing the chance of dislocations and infections were checked. Materials and methods We evaluated 73 patients who received a B-SlAC from January 2008 to January 2018. Group A, 40 oncological cases (22 primary tumors; 18 metastases); Group B, 33 failed THAs. We compared both Kaplan–Meier estimates of risk of failure and complication with the cumulative incidence function, taking account the competing risk of death. Cox proportional hazards model was utilized to identify possible predictors of instability and infection. Harris hip score HHS was used to record clinical outcomes. Results Medium follow-up was 80 months (24–137). Average final HHS was 61 (28–92), with no differences within the two groups (p > 0.05). The probabilities of failure and complications were 57% and 26%, respectively, lower in the oncologic group than in the rTHA group (p =0 .176; risk 0.43) (p = 0.52; risk 0.74). Extended ileo-femoral approach and proximal femur replacement (p =0.02, risk ratio = 3.2; p = 0.04, rr = 2.1) were two significant independent predictors for dislocations, while belonging to group B (p = 0.04, rr = 2.6) was predictable for infections. Conclusion Burch–Schneider-like antiprotrusio cages are a classical non-biological acetabular reconstruction method that surgeons should bear in mind when facing gross periacetabular bone losses, independently of their cause. However, dislocation and infection rates are high. Whenever possible, we suggest preserving the proximal femur in revision THA, and to use a less-invasive postero-lateral approach to reduce dislocation rates in non-oncologic cases.

scholarly journals Mid-term result of acetabular reconstruction using a Kerboull-type acetabular reinforcement device with hydroxyapatite impaction

2020 ◽  
pp. 221049172097183
Author(s):  
Hidetatsu Tanaka ◽  
Daisuke Chiba ◽  
Norikazu Yamada ◽  
Masahiko Tanaka ◽  
Yoshiyuki Kuwahara ◽  
...  
Keyword(s):  
Survival Rates ◽  
Acetabular Reconstruction ◽  
Type Ii ◽  
Term Result ◽  
Acetabular Bone ◽  
Kaplan Meier ◽  
Acetabular Bone Defects ◽  
The Mean ◽  
Mid Term Results ◽  
Reinforcement Device

The aim of this study is to investigate the mid-term results of 29 hips in 26 patients who underwent acetabular reconstruction using a Kerboull-type acetabular reinforcement device and impaction with hydroxyapatite (HA) granules. The acetabular bone defects were AAOS type II for six hips and type III for 23 hips. The mean Merle d’Aubigné clinical scores were significantly improved after operation. Six hips developed implant migration and breakage, and five of six hips were revised after an average of 5.5 (range 2.0–8.8) years. All hips with thickness of the grafted HA less than 10 mm were stable. As the HA became thicker, the failure rate were significantly increased. The Kaplan–Meier survival rates at 10 years were 73.2%, with 100% and 67.0% for AAOS type II and III defect respectively as the end point was failure condition. Reconstruction using a Kerboull-type acetabular reinforcement device and impaction with HA granules was an alternative method in the absence of adequate allografts.

A graphic guide to the percutaneous tripod acetabular reconstruction for metastatic cancer

2021 ◽  
Author(s):  
Rui Yang ◽  
Jichuan Wang ◽  
Megan M. Mizera ◽  
Sandip P. Tarpada ◽  
Mani Seetharaman ◽  
...  
Keyword(s):  
Metastatic Cancer ◽  
Acetabular Reconstruction

Long-term results of acetabular reconstruction using irradiated allograft bone

2018 ◽  
Vol 100-B (11) ◽  
pp. 1449-1454 ◽  
Author(s):  
C. M. Green ◽  
S. C. Buckley ◽  
A. J. Hamer ◽  
R. M. Kerry ◽  
T. P. Harrison
Keyword(s):  
At Risk ◽  
Aseptic Loosening ◽  
Acetabular Component ◽  
Long Term Results ◽  
Acetabular Reconstruction ◽  
Allograft Bone ◽  
Patients At Risk ◽  
Irradiated Allograft

Aims The management of acetabular defects at the time of revision hip arthroplasty surgery is a challenge. This study presents the results of a long-term follow-up study of the use of irradiated allograft bone in acetabular reconstruction. Patients and Methods Between 1990 and 2000, 123 hips in 110 patients underwent acetabular reconstruction for aseptic loosening, using impaction bone grafting with frozen, irradiated, and morsellized femoral heads and a cemented acetabular component. A total of 55 men and 55 women with a mean age of 64.3 years (26 to 97) at the time of revision surgery are included in this study. Results At a mean follow-up of 16.9 years, there had been 23 revisions (18.7%), including ten for infection, eight for aseptic loosening, and three for dislocation. Of the 66 surviving hips (58 patients) that could be reassessed, 50 hips (42 patients; 75.6%) were still functioning satisfactorily. Union of the graft had occurred in all hips with a surviving implant. Survival analysis for all indications was 80.6% at 15 years (55 patients at risk, 95% confidence interval (CI) 71.1 to 87.2) and 73.7% at 20 years (eight patients at risk, 95% CI 61.6 to 82.5). Conclusion Acetabular reconstruction using frozen, irradiated, and morsellized allograft bone and a cemented acetabular component is an effective method of treatment. It gives satisfactory long-term results and is comparable to other types of reconstruction. Cite this article: Bone Joint J 2018;100-B:1449–54.

Retrieval and Radiographic Analysis of the Contour Antiprotrusio Cage

2017 ◽  
Vol 27 (4) ◽  
pp. 378-381 ◽  
Author(s):  
Jonathan M. Vigdorchik ◽  
Richard S. Yoon ◽  
Susannah L. Gilbert ◽  
Joseph D. Lipman ◽  
Mathias P. Bostrom
Keyword(s):  
Average Length ◽  
Biomechanical Analysis ◽  
Acetabular Reconstruction ◽  
Pelvic Discontinuity ◽  
Intact Group ◽  
Future Design ◽  
Severe Bone Loss ◽  
Macroscopic Findings ◽  
Centre Of Rotation ◽  
Methods Of Treatment

Introduction Acetabular reconstruction in the setting of severe bone loss or pelvic discontinuity remains a challenging problem. Multiple methods of treatment have been described including antiprotrusio cages (APCs). The objective of this study is to combine biomechanical analysis of retrieved APCs with radiographic and clinical data to determine which factors influence or predict APC failure. Methods 41 APCs were identified. Sequential radiographs were examined for cage and polyethylene cup abduction angles, change in centre of rotation, screw placement, progression of cage failure, and failure mechanism. Cages were manually examined for gross macroscopic findings, breakage, and the location of breakage. High-resolution microscopy was used for further analysis. Results 24 cages were included in the analysis. Mean age of patients was 64.5 years (range 43-85 years); average length of implantation was 42.5 months (range 3-108 months). Average cage abduction angles were 56°; abduction for the cemented polyethylene cup was 44°. 14 of 24 cages were broken; 10 were intact. Of the broken cages, 10/14 broke through a screw hole in the ischial flange or just superior to the ischial flange. In the intact group, 6/10 failed due to pullout of the ischial screws. Discussion All cages had superior and lateralised centres of rotation. The majority of cages failed due to breakage or pullout at the ischial flange. Pelvic discontinuity was a large risk factor for a broken cage. Future design and technique modifications may result in superior outcomes in these complex acetabular reconstructions.

Anterior Fresh Frozen Structural Allografts in the Thoracic and Lumbar Spine

Spine ◽  
1995 ◽  
Vol 20 (12) ◽  
pp. 1410-1418 ◽  
Author(s):  
Keith H. Bridwell ◽  
Lawrence G. Lenke ◽  
Kevin W. McEnery ◽  
Christy Baldus ◽  
Kathy Blanke
Keyword(s):  
Lumbar Spine ◽  
Thoracic And Lumbar Spine ◽  
Fresh Frozen ◽  
Structural Allografts

Allograft Chip Incorporation in Acetabular Reconstruction

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Sebastian Butscheidt ◽  
Simon von Kroge ◽  
Julian Stürznickel ◽  
Frank Timo Beil ◽  
Thorsten Gehrke ◽  
...  
Keyword(s):  
Acetabular Reconstruction
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