scholarly journals Proximal Femoral Allograft for Major Segmental Femoral Bone Loss: A Systematic Literature Review

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
B. A. Rogers ◽  
A. Sternheim ◽  
D. Backstein ◽  
O. Safir ◽  
A. E. Gross
Keyword(s):  
Bone Loss ◽  
Hip Arthroplasty ◽  
Surgical Techniques ◽  
Stress Shielding ◽  
Review Article ◽  
Revision Hip Arthroplasty ◽  
Femoral Bone ◽  
Endoprosthetic Reconstruction ◽  
Press Fit ◽  
Impaction Allografting

As the indications for total hip arthroplasty increase, the prevalence of extensive proximal femoral bone loss will increase as a consequence of massive osteolysis, stress shielding and multiple revisions. Proximal femoral bone stock deficiency provides a major challenge for revision hip arthroplasty and is likely to account for a significant future caseload. Various surgical techniques have been advocated included impaction allografting, distal press-fit fixation and massive endoprosthetic reconstruction. This review article provides a systematic review of the current literature to assess the outcome of revision hip arthroplasty using allograft to reconstruction massive proximal femoral bone loss.

Femoral Impaction Allografting for Significant Bone Loss in Revision Hip Arthroplasty

2017 ◽  
Vol 27 (3) ◽  
pp. 281-285 ◽  
Author(s):  
Thomas A.J. Goff ◽  
Peter Bobak
Keyword(s):  
Bone Loss ◽  
Femoral Component ◽  
Hip Arthroplasty ◽  
Revision Arthroplasty ◽  
Bone Allograft ◽  
Revision Hip Arthroplasty ◽  
Stem Subsidence ◽  
Impaction Allografting ◽  
Component Revision

Introduction Femoral impaction bone allografting in revision hip arthroplasty facilitates physiological reconstruction with restoration of bone stock, allowing implantation of a standard cemented femoral component. The purpose of this study was to report our experience in femoral component revision arthroplasty with impaction morsellised cancellous bone allograft using custom impactors and a cemented triple-taper polished stem. Methods Retrospective analysis of all cases of femoral component revision hip arthroplasty with impaction bone grafting undertaken by a single surgeon from 2005 to 2011. Outcome measures included radiographic analysis of stem subsidence over time, graft remodelling and incorporation, and clinical progress. Results We reviewed 47 consecutive hips in 44 patients, mean age 62 years (37-88). Femoral impaction with allograft was performed as either single stage (41 cases) or 2-stage (6 cases) procedures. All patients received a cemented C-stem prosthesis. The mean follow-up period was 5.1 (1.3-9.4) years. The median pre-operative bone defect score was 3 (interquartile range [IQR] 2-3) using the Endo-Klinik classification. Radiological evidence of graft incorporation was observed in 89% (281 of 315 zones) with additional remodelling observed in 33% (103 of 315 zones). The median stem subsidence at 1-year follow-up was 1.1 mm (standard deviation [SD] 1.24 mm, range 0-6 mm). The median Oxford Hip Score at the most recent follow-up was 36.5. To date no femoral component has undergone further revision. Conclusions Encouraging results have been obtained with this technique for the treatment of significant bone loss in revision hip arthroplasty, allowing implantation of a standard prosthesis.

scholarly journals Results of uncemented distal locked prosthesis in revision hip arthroplasty with proximal femoral bone loss: A retrospective study

2013 ◽  
Vol 47 (1) ◽  
pp. 83 ◽  
Author(s):  
JawahirA Pachore ◽  
SiddharthB Joglekar ◽  
KrishnaKiran Eachempati ◽  
Sanjay Agarwala ◽  
HariRam Jhunjhunwala
Keyword(s):  
Retrospective Study ◽  
Bone Loss ◽  
Hip Arthroplasty ◽  
Revision Hip Arthroplasty ◽  
Femoral Bone

Reconstruction of Proximal Femoral Bone Loss using Autogenous Unicortical Iliac Bone Plate in Revision Hip Arthroplasty

2002 ◽  
Vol 37 (4) ◽  
pp. 489
Author(s):  
Young Min Kim ◽  
Hee Joong Kim ◽  
Sang Rim Kim ◽  
Kee Hyung Rhyu ◽  
Soo Taek Lim ◽  
...  
Keyword(s):  
Bone Loss ◽  
Hip Arthroplasty ◽  
Iliac Bone ◽  
Revision Hip Arthroplasty ◽  
Bone Plate ◽  
Femoral Bone

scholarly journals Allogenic bone graft for femoral defect augmentation in hip revision arthroplasty: A case series

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Nils Wirries ◽  
Michael Skutek ◽  
Marcus Örgel ◽  
Stefan Budde ◽  
Alexander Derksen ◽  
...  
Keyword(s):  
Bone Loss ◽  
Bone Graft ◽  
Cortical Bone ◽  
Hip Arthroplasty ◽  
Case Series ◽  
Revision Arthroplasty ◽  
Revision Hip Arthroplasty ◽  
Femoral Bone ◽  
Allogenic Bone

Cortical bone loss in revision hip arthroplasty requires an adequate stabilization to achieve a durable implant fixation. This case series shall illustrate possible indications for the use of allogenic grafts in revision hip arthroplasty. Twelve patients with femoral bone loss were treated with allografts. In addition to established clinical scores, the radiological follow-ups were analyzed for hints of implants loosening and the osteointegration of the allografts. After a mean follow-up of 3.0 years the mHHS was 61.3 points and the UCLA 3.8. One patient showed a non-progressive radiolucency around the hip implant. The osteointegration of all allogenic grafts happened on time. Up to the last follow-up no revision surgery of the hip implants and the associated femoral bone graft was observed. Allogenic bone grafts present a method for biological stabilization in situations of large femoral cortical bone defects in revision hip arthroplasty.

scholarly journals A Contemporary Classification System of Femoral Bone Loss in Revision Total Hip Arthroplasty

2021 ◽  
Vol 9 ◽  
pp. 134-140
Author(s):  
Bryeson Rodgers ◽  
Gabrielle Wernick ◽  
Gabrielle Roman ◽  
Christopher P. Beauchamp ◽  
Mark J. Spangehl ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Bone Loss ◽  
Hip Arthroplasty ◽  
Classification System ◽  
Revision Total Hip Arthroplasty ◽  
Femoral Bone ◽  
Total Hip

scholarly journals Survivorship and clinical outcomes of proximal femoral replacement in non-neoplastic primary and revision total hip arthroplasty: a systematic review

2021 ◽  
Vol 22 (S2) ◽  
Author(s):  
Fabio Mancino ◽  
Vincenzo Di Matteo ◽  
Fabrizio Mocini ◽  
Giorgio Cacciola ◽  
Giuseppe Malerba ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Hip Arthroplasty ◽  
Bone Loss ◽  
Clinical Outcomes ◽  
Hip Arthroplasty ◽  
Complication Rate ◽  
Reoperation Rate ◽  
Revision Total Hip Arthroplasty ◽  
Femoral Bone ◽  
Review Of The Literature

Abstract Background Several studies have evaluated the survivorship and clinical outcomes of proximal femoral replacement (PFR) in complex primary and revision total hip arthroplasty with severe proximal femoral bone loss; however, there remains no consensus on the overall performance of this implant. We therefore performed a systematic review of the literature in order to examine survivorship and complication rates of PFR usage. Methods A systematic review of the literature according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed. A comprehensive search of PubMed, MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews was conducted for English articles using various combinations of keywords. Results In all, 18 articles met the inclusion criteria. A total of 578 PFR were implanted. The all-cause reoperation-free survivorship was 76.6%. The overall complication rate was 27.2%. Dislocation was the most common complication observed and the most frequent reason for reoperation with an incidence of 12.8 and 7.6%, respectively. Infection after PFR had an incidence of 7.6% and a reoperation rate of 6.4%. The reoperation rate for aseptic loosening of the implant was 5.9%. Overall, patients had improved outcomes as documented by postoperative hip scores. Conclusion PFR usage have a relatively high complication rate, however, it remains an efficacious treatment option in elderly patients with osteoporotic bone affected by severe proximal femoral bone loss. Modular designs have shown reduced dislocations rate and higher survivorship free from dislocation. However, PFR should only be used as salvage procedure when no other reconstruction options are available.

scholarly journals Experience in use of Wagner SL Revision Stem for Revision Hip Arthroplasty

2014 ◽  
pp. 40-45
Author(s):  
G. M. Kavalerskiy ◽  
V. Yu. Murylyov ◽  
Ya. A. Rukin ◽  
M. Yu. Kholodaev ◽  
P. M. Elizarov
Keyword(s):  
Hip Arthroplasty ◽  
Femoral Stem ◽  
Revision Hip Arthroplasty ◽  
Femoral Bone ◽  
Defect Type ◽  
Hip Implant ◽  
Femoral Defect ◽  
Revision Stem

Experience in revision hip arthroplasty with change of femoral stem was analyzed for 165 patients. In 107 operations (64.8%) Wagner SL Revision Stems were used, in the rest of cases - femoral components of other manufacturers. Distribution of patients by femoral defect type by Paprovsky was the following: I type - 27 patients, II type - 75, IIIA type - 59, IIIB and IV type - 4 patients. Good results at use of Wagner SL Revision Stems and stems of other manufacturers were comparable and made up 87.9 and 86.2%, respectively. Achieved data enabled to make conclusion that Wagner SL Revision Stem use is reasonable for patients with hip implant instability in I-IIIA femoral bone deficit, as they are cheaper than the modular revision stems and their design prevents the wear in the area of modular junction.

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