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. 2022 Jul;10(7):568-575.
doi: 10.22038/ABJS.2021.53380.2666.

Revision of Total Hip Arthroplasty with Acetabular Bone Defects: Are Biological Grafts Really Better than Synthetic Bone Graft Substitutes?

Luca Costanzo Comba  1 , Enrico Bellato  2 , Danilo Colombero  2 , Lorenzo Mattei  3 , Antongiulio Marmotti  2 , Filippo Castoldi  2
Affiliations

Revision of Total Hip Arthroplasty with Acetabular Bone Defects: Are Biological Grafts Really Better than Synthetic Bone Graft Substitutes?

Luca Costanzo Comba et al. Arch Bone Jt Surg. 2022 Jul.

Abstract

Background: Acetabular aseptic loosening due to bone defect in total hip arthroplasty revisions is a great challenge and several solutions have been proposed, but a broadly accepted consensus in the literature has not been reached yet. The aim of this study is to compare the clinical and radiographic results of acetabular bone defects treatment with biological-only graft or with a mixture of bone graft substitute and biological graft.

Methods: 33 patients had revision hip arthroplasty using impaction grafting with biological-only graft (21 patients, Group A) or a 1/3 mixture of allograft and tricalcium phosphate bone graft substitute (12 patients, Group B). Patients were reassessed at a minimum of one year after surgery with new x-rays and the Harris Hip Score (HHS).

Results: Survivorship of bone graft was 86% in Group A and 100% in Group B at a mean follow-up of 35 months. No statistical difference between the two groups was found in terms of implants survivorship (P=0.28), clinical (P=0.08) or radiographic (P=0.27) outcomes.

Conclusion: In our experience the use of tricalcium phosphate bone graft substitutes in combination with allo and autograft provides good outcomes, low risk of failure and great clinical and radiographic results. Further investigations on larger samples are needed to impact clinical practice.

Keywords: abbr.

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Figures

Figure 1
Figure 1
A 73 years old patient affected by Paprosky 3b acetabular defect treated with a cementless implant (Delta One TT®, Lima) associated with bone allograft. A (preoperative x-ray); B (immediate postoperative x-ray), C (36 months follow-up)
Figure 2
Figure 2
A 56 years old patient affected by Paprosky 2a acetabular defect and cup migration treated with a cementless implant (Delta One TT®, Lima) associated with Vitoss® bone graft substitute: A (preoperative x-ray); B (immediate postoperative x-ray), C (12 months follow-up)
Figure 3
Figure 3
A 65 years old patient treated with a cementless implant (Delta One TT®, Lima) associated with metal augment
Figure 4
Figure 4
A 62 years old patient with a cementless implant (Delta One TT®, Lima) associated with metal augment and bone allograft. A (immediate postoperative x-ray), B (implant failure at 12 months follow-up). Bone graft (red arrow)
See this image and copyright information in PMC

References

    1. Learmonth ID, Young C, Rorabeck C. The operation of the century: total hip replacement. Lancet. 2007;370(9597):1508–19. - PubMed
    1. Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. Jbjs. 2007;89(4):780–5. - PubMed
    1. Kurcz B, Lyons J, Sayeed Z, Anoushiravani AA, Iorio R. Osteolysis as it pertains to total hip arthroplasty. Orthopedic Clinics. 2018;49(4):419–35. - PubMed
    1. Haynes JA, Stambough JB, Sassoon AA, Johnson SR, Clohisy JC, Nunley RM. Contemporary surgical indications and referral trends in revision total hip arthroplasty: a 10-year review. The journal of arthroplasty. 2016;31(3):622–5. - PubMed
    1. Bozic KJ, Kurtz SM, Lau E, Ong K, Vail TP, Berry DJ. The epidemiology of revision total hip arthroplasty in the United States. JBJS. 2009;91(1):128–33. - PubMed

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