Use of cemented long femoral stems associated with morcelled bone graft for Total Hip Arthrosplasty (THA) in revision surgery

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Published: Nov 16, 2012
DOI: https://doi.org/10.15417/74
Keywords:
RTHA, Impacted bone graft, Bone loss, Cemented long stem, Ling, Uncemented longstem

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German Garabano
Hospital Britanico de Buenos Aires
Fernando Lopreite
Htal Britanico de Bs As.
Diego Mana Pastrian
Htal Britanico de Bs As
Javier dal Lago
Htal Britanico de Bs As.
Hernan del Sel
Htal Britanico de Bs As

Abstract

IntroductionCurrently, there are different treatment options to perform a revision of a failed total hip arthroplasty (RTHA). The use of cemented long femoral stems associated with the use of morcelled bone graft is one of these modalities for the RTC with poor quality and loss of bone capital.MethodsWe analyze retrospectively 33 RTHA, with an average follow-up of 4 years. The causes of the review were in 28 cases mechanical losing, 3 peri-prosthetic fractures and 2 failures of osteosynthesis. Long stems cups and 30 were used in all cases (90%) cases I use ground bone graft.ResultsWith regard to the behaviour of the stems the average sinking was 4 mm. See the graft integration in 27(90%) of the 30 cases, had 3 radiological failures where the stems were sunk in two opportunities 8 mm and the remaining 12 mm. In addition there were 2 false tracks (6%), 2 dislocations (6%) and 2 pseudoarthrosis of major trochanter (6%)ConclusionThe use of cemented long femoral stems associated with impacted bone graft in cases where the distal femur is not suitable to receive a uncemented stem of distal fixation impresses be a proper reconstruction technique for RTHA with bone capital deficit. It must be made in centers of reference by experienced hands that it is not free of complications. 

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How to Cite
Garabano, G., Lopreite, F., Mana Pastrian, D., dal Lago, J., & del Sel, H. (2012). Use of cemented long femoral stems associated with morcelled bone graft for Total Hip Arthrosplasty (THA) in revision surgery. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 77(2), 104-111. https://doi.org/10.15417/74
Issue
Vol 77 No 2 (2012)
Section
Clinical Research
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References

1. Baker R, Toms A, Kuiper JH. Reconstruction of femoral defects in revision hip surgery. J Bone Joint Surg Br 2006; 88-B: 832-6.

2. Coyte PC, Young W, Williams JI. Devolution of hip and knee replacement surgery? Can J Plast Surg 1998;39:373-8.

3. Randhawa K, Houssain FS, Lawrence T. A prospective study of hip revision surgery using the Exeter long-stem prosthesis. J Orthop Traumatol 2009;10:159.

4. Gie GA, Sierra R, Tsiridis E. The use of long cemented stems for femoral impaction grafting in revision total hip arthroplasty. J Bone Joint Surg Am 2008;90:1330-6.

5. Haddad F, Duncan CP. Cortical allograft struts in the treatment of periprothesis femoral fractures. Instr Course Lect 2003;52:291-300.

6. Gie GA, Linder L, Ling RSM. Impacted cancellous allograft and cement for revision total hip arthroplasty. J Bone Join Surg Br 1993;75:14-21.

7. Kavanagh BF, Fitzgerald RH Jr. Multiple revision for failed total hip arthroplasty not associated with infection. J Bone Joint Surg Am 1987;69:1144-9.

8. Murloy WF, Harris WH. Revision total hip arthroplasty with use of so-called second-generation cementing techniques for aseptic loosening of the femoral component. J Bone Joint Surg Am 1996;78:325-30.

9. Tsiridis E, Narvani AA, Gie GA. Impaction femoral allografting and cemented revision for periprosthesis femoral fractures. J Bone Joint Surg Br 2004;86-B:1124-32.

10. Hultmark P, Karrholm J. Cemented first time revision of the femoral component. J Arthrop 2000;15:551-61.

11. Berzins A, Summer DR,Wasielewski. Impacted particulate allograft for femoral revision total hip arthroplasty. J Arthroplasty 1996;11:500-6.

12. Callaghan JJ, Heiner AD, Brown TD. The basic science of impaction allografting in revision hip surgery. Insr Course Lect 2000;49:103-10.

13. Sloof TJJ, Huiskes R, Lemmens AJ. Bone grafting in total hip replacement for acetabular protrusion. Acta Orthop Scand 1984;55.593-6.

14. Ullmark G, Obrant KJ. Histology of impacted bone grafting incorporation. J Arthropalsty 2002;17:150-7.

15. Roffman M, Silbermann M, Mendes DG. Viability and osteogenecity of bone graft coated whit PMMA cement. Acta Orthop Scand 1982;53:513-19.

16. Ling RS, Timperley AJ, Linder L. Histology of cancellus impaction grafting in the femur. J Bone Joint Surg Br 1993;75:14-21.

17. Nelissen RGH, Bauer TW, Weidenheielm LRA. Revision hip arthroplasty with the use of cement and impaction grafting: histological analysis of four cases. J Bone Joint Surg Am 1995;77:412-22.

18. Nelissen RG, Garling EH. Influence of cement viscosity and cement mantle thickness on migration of the exert total hip prosthesis. J Arthropalsty 2005;20-4:521-8.

19. Pekkarinen J, Alho A, Lepisto J. Impaction bone grafting in revision hip surgery: a high incidence of complications. J Bone Joint Surg Br 2000;82:103-7.

20. Leopold SS, Rossemberg AG. Current status of impaction allografting for revision of a femoral component. Inst Course Lect 2000;49:111-8.

21. Knight JL, Helming C. Collarless polished tapered impaction grafting of the femur during revision total hip arthroplasty. J Arthroplasty 2000;15-2:159-65.

22. Krismer M, Biedermann R. The prediction of failure of stem en THR by measurement of early migration using EBRA-FCA. J Bone Joint Surg Br 1999;81-2:273-80.

23. Walker PS, Mai SF. Prediction of clinical outcome of THR from migration measurement on standard radiographs. J Bone Joint Surg Br 1995;77-5:705-14.

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