Hiroyuki Makita1, Marcel Kerboull2, Yutaka Inaba3, Taro Tezuka3, Tomoyuki Saito3, Luc Kerboull2. 1. Institut Marcel Kerboull, Paris, France; Department of Orthopaedic Surgery, Kanagawa Prefectural Ashigarakami Hospital, Kanagawa, Japan. 2. Institut Marcel Kerboull, Paris, France. 3. Department of Orthopaedic Surgery, Yokohama City University School of Medicine, Yokohama, Japan.
Abstract
BACKGROUND: The purpose of this study is to review our experience with Kerboull reinforcement device combined with bulk allograft for management of severe acetabular defects. METHODS: We investigated the results of revision total hip arthroplasty (THA) in 65 hips of 59 patients (10 male, 49 female) with Paprosky type 3A or 3B acetabular bone defects. Functional outcome was assessed using the Merle d'Aubigne hip score. Post-operative radiographs were examined for evidence of cup loosening. The mean age at revision THA was 59.1 years (23-85) and mean follow-up duration was 11.2 years (2-15). RESULTS: The Merle d'Aubigne hip score improved from 10.6 points (5-15) before surgery to 17.1 points (15-18) (P < .05) at the time of last investigation. In this series, mean coverage of the bone graft was 83.0% (34.6-100) of the loading portion in the horizontal plane on radiography immediately after revision. However, consolidation of the bone graft was completed within 12 months for all cases. There were 4 radiological failures due to acetabular aseptic loosening at a mean of 10.8 years (8-13) after index surgery; all 4 cases demonstrated massive bone loss that no part of the rounded plate could be placed on the host bone. Kaplan-Meier analysis showed that the 15.2-year survival rate was 85.1% (95% confidence interval 71-99) with re-revision surgery for any reason as the end point. CONCLUSION: Despite massive bone defects, we achieved favorable results for revision THA using bulk allograft and the Kerboull reinforcement device.
BACKGROUND: The purpose of this study is to review our experience with Kerboull reinforcement device combined with bulk allograft for management of severe acetabular defects. METHODS: We investigated the results of revision total hip arthroplasty (THA) in 65 hips of 59 patients (10 male, 49 female) with Paprosky type 3A or 3B acetabular bone defects. Functional outcome was assessed using the Merle d'Aubigne hip score. Post-operative radiographs were examined for evidence of cup loosening. The mean age at revision THA was 59.1 years (23-85) and mean follow-up duration was 11.2 years (2-15). RESULTS: The Merle d'Aubigne hip score improved from 10.6 points (5-15) before surgery to 17.1 points (15-18) (P < .05) at the time of last investigation. In this series, mean coverage of the bone graft was 83.0% (34.6-100) of the loading portion in the horizontal plane on radiography immediately after revision. However, consolidation of the bone graft was completed within 12 months for all cases. There were 4 radiological failures due to acetabular aseptic loosening at a mean of 10.8 years (8-13) after index surgery; all 4 cases demonstrated massive bone loss that no part of the rounded plate could be placed on the host bone. Kaplan-Meier analysis showed that the 15.2-year survival rate was 85.1% (95% confidence interval 71-99) with re-revision surgery for any reason as the end point. CONCLUSION: Despite massive bone defects, we achieved favorable results for revision THA using bulk allograft and the Kerboull reinforcement device.
Authors: Peter K Sculco; Timothy Wright; Michael-Alexander Malahias; Alexander Gu; Mathias Bostrom; Fares Haddad; Seth Jerabek; Michael Bolognesi; Thomas Fehring; Alejandro Gonzalez DellaValle; William Jiranek; William Walter; Wayne Paprosky; Donald Garbuz; Thomas Sculco Journal: HSS J Date: 2021-09-28
Authors: Tim Rolvien; Christian Friesecke; Sebastian Butscheidt; Thorsten Gehrke; Michael Hahn; Klaus Püschel Journal: Sci Rep Date: 2020-09-16 Impact factor: 4.379