scholarly journals Revision Hip Arthroplasty: Management of Bone Loss

10.5772/53249 ◽  
2013 ◽  
Author(s):  
Plamen Kinov ◽  
Peter Tivchev
Keyword(s):  
Bone Loss ◽  
Hip Arthroplasty ◽  
Revision Hip Arthroplasty

Proximal Femoral Reconstruction for Revision Hip Arthroplasty with Severe Bone Loss: A New Technique Using Autologous Bone Graft and a Proximally Loading Femoral Component

1997 ◽  
Vol 7 (1) ◽  
pp. 3-10 ◽  
Author(s):  
J. Alfaro Adrian ◽  
M. Emerton ◽  
D.W. Murray ◽  
P. Mclardy-Smith
Keyword(s):  
Bone Loss ◽  
Bone Graft ◽  
Hip Arthroplasty ◽  
Autologous Bone Graft ◽  
Revision Hip Arthroplasty ◽  
Severe Bone Loss ◽  
Successful Technique ◽  
A New Technique ◽  
Proximal Femoral Reconstruction

We report the results of a new method of reconstructing the femur in 22 patients with severe bone loss having revision hip arthroplasty. The calcar and metaphysis were reconstructed with cortico-cancellous autograft around a new modular hip replacement. The metaphyseal portion of the implant is free to slide on the stem and therefore loads the graft and, we believe, encourages bone graft incorporation. The stem gains cementless fixation distal to the area of bone loss, thus preventing fractures and allowing the areas of bone loss to heal. At the time of review at a mean of 3 years follow-up there had been no revisions (since then there has been one re-revision due to recurrence of infection). The modified D'Aubigné and Postel hip score improved from 7.3 to 15. In 17 patients the graft has incorporated, in 5 it has partially resorbed but the prosthesis remains secure. We conclude that this is a relatively simple and successful technique for overcoming the problem of major femoral bone loss.

scholarly journals Management of Periacetabular Bone Loss in Revision Hip Arthroplasty

2007 ◽  
Vol 465 ◽  
pp. 159-165 ◽  
Author(s):  
Petros J Boscainos ◽  
Catherine F Kellett ◽  
Anthony C Maury ◽  
David Backstein ◽  
Allan E Gross
Keyword(s):  
Bone Loss ◽  
Hip Arthroplasty ◽  
Revision Hip Arthroplasty

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.

Proximal Cementing for Revision Hip Arthroplasty

1998 ◽  
Vol 8 (2) ◽  
pp. 62-69 ◽  
Author(s):  
J. Alfaro-Adrian ◽  
R.W. Crawford ◽  
A. Wulke ◽  
D.W. Murray ◽  
P. Mclardy-Smith
Keyword(s):  
Bone Loss ◽  
Hip Arthroplasty ◽  
High Rate ◽  
Revision Hip Arthroplasty ◽  
Hip Revision ◽  
Risk Of Fracture ◽  
Slight Pain ◽  
Continued Use ◽  
A New Technique

We report the results of a new technique of proximal cement fixation in 41 patients having revision hip arthroplasty using the Oxford modular femoral component. This consists of two parts, a metaphised wedge and a stem. The metaphyseal wedge is cemented and applies the load proximally to encourage bone healing. The wedge is free to slide on an uncemented stem that gains fixation distal to areas of bone loss, with the intention of reducing the risk of fracture. The clinical and radiographic follow-up ranged from a minimum of 3 years to 7 years. There have been no re-revisions. Ninety percent of the patients had pain or slight pain. Despite a relatively high rate of early subsidence, we feel that our results are encouraging, and justify the continued use of this component in hip revision surgery.

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
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