Acetabular Cup Revision Arthroplasty Using Morselized Impaction Allograft

The rate of acetabular cup revision arthroplasty is gradually rising along with an increased risk of osteolysis and prosthesis loosening over time and an increase in life expectancy. The goals of revision total hip arthroplasty are: i) implant stability through reconstruction of large bone defects,...

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Autores principales: Lee, Joong-Myung, Kim, Tae-ho
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Hip Society 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5990533/
https://www.ncbi.nlm.nih.gov/pubmed/29896455
http://dx.doi.org/10.5371/hp.2018.30.2.65
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author Lee, Joong-Myung
Kim, Tae-ho
author_facet Lee, Joong-Myung
Kim, Tae-ho
author_sort Lee, Joong-Myung
collection PubMed
description The rate of acetabular cup revision arthroplasty is gradually rising along with an increased risk of osteolysis and prosthesis loosening over time and an increase in life expectancy. The goals of revision total hip arthroplasty are: i) implant stability through reconstruction of large bone defects, ii) restoration of range of motion and biomechanics of the hip joint, and iii) normalization of uneven limb lengths. In acetabular cup revision arthroplasty, stable fixation of acetabular components is difficult in the presence of severe bone loss (e.g., evidence suggests that it is challenging to achieve satisfactory results in cases of Paprosky type 3 or higher bone defects using conventional techniques). The author of this study performed acetabular revision to manage patients with large areas of defective bones by filling in with morselized impaction allografts. These allografts were irradiated frozen-stored femoral heads acquired from a tissue bank, and were applied to areas of an acetabular bone defect followed by insertion of a cementless cup. When this procedure was insufficient to obtain primary fixation, a tri-cortical or structural allograft using a femoral head was carried out. Structural stability and bone incorporation were confirmed via long-term follow-up. This study aims to review conventional surgical techniques and verify the utility of surgical procedures by analyzing the author's surgical methods and discussing case reports.
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spelling pubmed-59905332018-06-12 Acetabular Cup Revision Arthroplasty Using Morselized Impaction Allograft Lee, Joong-Myung Kim, Tae-ho Hip Pelvis Review Article The rate of acetabular cup revision arthroplasty is gradually rising along with an increased risk of osteolysis and prosthesis loosening over time and an increase in life expectancy. The goals of revision total hip arthroplasty are: i) implant stability through reconstruction of large bone defects, ii) restoration of range of motion and biomechanics of the hip joint, and iii) normalization of uneven limb lengths. In acetabular cup revision arthroplasty, stable fixation of acetabular components is difficult in the presence of severe bone loss (e.g., evidence suggests that it is challenging to achieve satisfactory results in cases of Paprosky type 3 or higher bone defects using conventional techniques). The author of this study performed acetabular revision to manage patients with large areas of defective bones by filling in with morselized impaction allografts. These allografts were irradiated frozen-stored femoral heads acquired from a tissue bank, and were applied to areas of an acetabular bone defect followed by insertion of a cementless cup. When this procedure was insufficient to obtain primary fixation, a tri-cortical or structural allograft using a femoral head was carried out. Structural stability and bone incorporation were confirmed via long-term follow-up. This study aims to review conventional surgical techniques and verify the utility of surgical procedures by analyzing the author's surgical methods and discussing case reports. Korean Hip Society 2018-06 2018-06-04 /pmc/articles/PMC5990533/ /pubmed/29896455 http://dx.doi.org/10.5371/hp.2018.30.2.65 Text en Copyright © 2018 by Korean Hip Society http://creativecommons.org/licenses/by-nc/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Lee, Joong-Myung
Kim, Tae-ho
Acetabular Cup Revision Arthroplasty Using Morselized Impaction Allograft
title Acetabular Cup Revision Arthroplasty Using Morselized Impaction Allograft
title_full Acetabular Cup Revision Arthroplasty Using Morselized Impaction Allograft
title_fullStr Acetabular Cup Revision Arthroplasty Using Morselized Impaction Allograft
title_full_unstemmed Acetabular Cup Revision Arthroplasty Using Morselized Impaction Allograft
title_short Acetabular Cup Revision Arthroplasty Using Morselized Impaction Allograft
title_sort acetabular cup revision arthroplasty using morselized impaction allograft
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5990533/
https://www.ncbi.nlm.nih.gov/pubmed/29896455
http://dx.doi.org/10.5371/hp.2018.30.2.65
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