Johannes Buckup1, Emiliano Alvarez Salinas2, Alejandro Gonzalez Della Valle1, Friedrich Boettner1. 1. Adult Reconstruction & Joint Replacement Division, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA. 2. Adult Reconstruction & Joint Replacement Division, Hospital Austral, Avenida Peron 1500, Pilar, Provincia de Buenos Aires Argentina.
Abstract
BACKGROUND: Revision total hip arthroplasty in cases with severe acetabular bone loss is challenging. In the presence of combined cavitary and segmental defects without superior acetabular coverage, reconstructions with a structural acetabular allograft protected by a cage or a custom-made triflange cage have been the treatment of choice. The current paper describes an impaction grafting into a mesh for uncontained defects in revision total hip arthroplasty. DESCRIPTION OF TECHNIQUE: After restoring containment with a mesh fixed with small fragment screws, defects were restored using impaction grafting combined with a cemented all-polyethylene cup. PATIENTS AND METHODS: Fourteen consecutive acetabular impaction graftings were performed by two surgeons. All patients had a type 3B defect according to the Paprosky classification. RESULTS: No re-revisions or radiographic failure was detected in the early follow-up period. CONCLUSION: Impaction grafting into a mesh is an interesting treatment option to restore bone in combined cavitary and segmental defects.
BACKGROUND: Revision total hip arthroplasty in cases with severe acetabular bone loss is challenging. In the presence of combined cavitary and segmental defects without superior acetabular coverage, reconstructions with a structural acetabular allograft protected by a cage or a custom-made triflange cage have been the treatment of choice. The current paper describes an impaction grafting into a mesh for uncontained defects in revision total hip arthroplasty. DESCRIPTION OF TECHNIQUE: After restoring containment with a mesh fixed with small fragment screws, defects were restored using impaction grafting combined with a cemented all-polyethylene cup. PATIENTS AND METHODS: Fourteen consecutive acetabular impaction graftings were performed by two surgeons. All patients had a type 3B defect according to the Paprosky classification. RESULTS: No re-revisions or radiographic failure was detected in the early follow-up period. CONCLUSION: Impaction grafting into a mesh is an interesting treatment option to restore bone in combined cavitary and segmental defects.
Entities:
Keywords:
acetabular bone loss; allograft; impaction grafting; metal mesh; revision total hip arthroplasty
Authors: Mathias P Bostrom; Andrew P Lehman; Robert L Buly; Stephen Lyman; Bryan J Nestor Journal: Clin Orthop Relat Res Date: 2006-12 Impact factor: 4.176
Authors: Paul S Issack; Markku Nousiainen; Burak Beksac; David L Helfet; Thomas P Sculco; Robert L Buly Journal: Am J Orthop (Belle Mead NJ) Date: 2009-11
Authors: Sanne van der Donk; Pieter Buma; Tom J J H Slooff; Jean W M Gardeniers; B Willem Schreurs Journal: Clin Orthop Relat Res Date: 2002-03 Impact factor: 4.176
Authors: J A D'Antonio; W N Capello; L S Borden; W L Bargar; B F Bierbaum; W G Boettcher; M E Steinberg; S D Stulberg; J H Wedge Journal: Clin Orthop Relat Res Date: 1989-06 Impact factor: 4.176
Authors: Anna Di Laura; Johann Henckel; Elisabetta Dal Gal; Mohammed Monem; Maria Moralidou; Alister J Hart Journal: BMC Musculoskelet Disord Date: 2021-02-20 Impact factor: 2.362