Femoral revision with impaction bone grafting and a cemented polished tapered stem

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• 作者：Prof. Dr. I.C. Heyligers (1)
  B.W. Schreurs (2)
  E.H. van Haaren (3)
  
• 关键词：Bone loss ; Rotation ; Segmental defects ; Harris Hip Score ; Allograft ; Knochenverlust ; Rotation ; Segmentaler Defekte ; Harris Hip Score ; Allotransplantat
• 刊名：Operative Orthop?die und Traumatologie
• 出版年：2014
• 出版时间：April 2014
• 年：2014
• 卷：26
• 期：2
• 页码：156-161
• 全文大小：501 KB
• 参考文献：1. Bolder SB, Schreurs BW, Verdonschot N et al (2004) Wire mesh allows more revascularization than a strut in impaction bone grafting: an animal study in goats. Clin Orthop Relat Res 423:280-86 CrossRef
  2. Dunlop DG, Brewster NT, Madabhushi SP et al (2003) Techniques to improve the shear strength of impacted bone graft: the effect of particle size and washing of the graft. J Bone Joint Surg Am 85:639-46
  3. Gie GA, Linder L, Ling RS et al (1993) Impacted cancellous allografts and cement for revision total hip arthroplasty. J Bone Joint Surg Br 75:14-1
  4. Halliday BR, English HW, Timperly AJ et al (2003) Femoral impaction grafting with cement in revision total hip replacement. Evolution of the technique and results. J Bone Joint Surg Br 85:809-17
  5. Nelissen RG, Bauer TW, Weidenhielm LR et al (1995) Revision hip arthroplasty with the use of cement and impaction grafting. Histological analysis of four cases. J Bone Joint Surg Am 77:412-22
  6. Stroet MA te, Gardeniers JW, Verdonschot N et al (2012) Femoral component revision with use of impaction bone-grafting and a cemented polished stem: a concise follow-up, at fifteen to twenty years, of a previous report. J Bone Joint Surg Am 94(23)
  7. Schreurs BW, Buma P, Huiskes R et al (1994) Morsellized allografts for fixation of the hip prosthesis femoral component. A mechanical and histological study in the goat. Acta Orthop Scand 65:267-75 CrossRef
  8. Schreurs BW, Huiskes R, Slooff TJ (1991) The initial stability of cemented and noncemented stems, fixated with a bone grafting technique. Orthop Trans 15:439-40
  9. Van Donk S der, Weernink T, Buma P et al (2003) Rinsing allografts improves bone and tissue ingrowth. Clin Orthop Relat Res 408:302-10 CrossRef
  10. Haaren EH van, Smit TH, Phipps K et al (2005) Tricacium-phosphate and hydroxyapatite bone-graft extender for use in impaction grafting revision surgery. An in vitro study on human femora. J Bone Joint Surg Br 87(2):267-71 CrossRef
  11. Haaren EH van, Smit TH, Veen AJ van der et al (2005) A bioresorbable molding mesh for impaction grafting revision hip surgery. Clin Orthop Relat Res 432:167-73 CrossRef
  12. Haaren EH van, Zwaard BC van der, Veen AJ van der et al (2008) Effect of long-term preservation on the mechanical properties of cortical bone. Acta Orthopaedica 79(5):708-16 CrossRef
  
• 作者单位：Prof. Dr. I.C. Heyligers (1)
  B.W. Schreurs (2)
  E.H. van Haaren (3)
  
  1. Department of Orthopaedics, Atrium MC Heerlen, SHE, Faculty of Health, Medicine and Life Sciences, University Maastricht, 6401, Heerlen, The Netherlands
  2. Department of Orthopaedics, Radboud University, Nijmegen, The Netherlands
  3. Department of Orthopaedics, Orbis MC, Sittard, The Netherlands
  
• ISSN：1439-0981

文摘

Objective Biological repair of femoral bone loss using bone impaction grafting. Reconstruction of the centre of rotation of the hip using a cemented stem, the size and offset of which are at the discretion of the surgeon. Indications Femoral implant loosening with bone loss. Contraindications Infection, neurological disorders, noncompliant patient. Surgical technique Extraction of the loose femoral implant, cortical reconstruction using meshes if required, impaction bone grafting with special instruments, cement fixation of a polished tapered stem. Postoperative management Individualized period of bed rest and limited weight bearing. Results Impaction bone grafting and a cemented polished stem were used to perform 33?femoral reconstructions. After a mean follow-up of 15?years, no femoral reconstruction had to be revised. One unrecognized intraoperative fracture healed after nonsurgical treatment, three postoperative femoral fractures healed after plate fixation with the stem left in situ. The average Harris Hip Score improved from 49?prior to surgery to 85?points thereafter. Kaplan–Meier analysis with femoral revision for any reason as the end point showed a survival rate of 100-.