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. 2024 Jun 24;32(2):e273746.
doi: 10.1590/1413-785220243202e273746. eCollection 2024.

LONG-TERM OUTCOMES OF USING VARIOUS GRAIN ALLOGRAFT SIZES IN PAPROSKY TYPE 3

Patcharavit Ploynumpon  1 , Rutthakorn Sritumma  1 , Thakrit Chompoosang  1
Affiliations

LONG-TERM OUTCOMES OF USING VARIOUS GRAIN ALLOGRAFT SIZES IN PAPROSKY TYPE 3

Patcharavit Ploynumpon et al. Acta Ortop Bras. .

Abstract
in English, Portuguese

Introduction: Severe acetabular bone defects can pose challenges in revision total hip replacement. The use of structural allografts and various sizes of grain allografts has been proposed as an alternative surgical technique for treating Paprosky type 3 acetabular defects. This study aimed to evaluate the long-term outcomes and potential complications associated with this approach.

Methods: A retrospective review was performed on 102 hip reconstructions in patients with major acetabular bone loss, including 81 cases of type 3A and 21 cases of type 3B according to Paprosky's classification. Surgical procedures involved the use of structural allografts and various sizes of grain allografts in both reinforcement ring group and cementless cups group.

Results: At a mean follow-up of 82.75 months, 76% of hips had no complications, while The others experienced pain changes in the cup position, post-operative dislocations, and infections. The mean pre-operative Modified Harris Hip Score improved in both groups at the last follow-up.

Conclusion: The use of structural allografts and various sizes of grain allografts for treating type 3 acetabular defects in revision total hip replacement showed promising long-term outcomes and a low rate of complications. Level of Evidence IV; Retrospective Case Series.

Introdução: Defeitos ósseos acetabulares graves podem representar desafios na revisão da artroplastia total do quadril. O uso de aloenxertos estruturais e aloenxertos de grãos de vários tamanhos foram propostos como uma técnica cirúrgica alternativa para o tratamento de defeitos acetabulares Paprosky tipo 3. O objetivo deste estudo foi avaliar os resultados de longo prazo e as possíveis complicações associadas a essa abordagem.

Métodos: Foi realizada uma revisão retrospectiva de 102 reconstruções de quadril em pacientes com grande perda óssea acetabular, incluindo 81 casos do tipo 3A e 21 casos do tipo 3B de acordo com a classificação de Paprosky. Os procedimentos cirúrgicos envolveram o uso de aloenxertos estruturais e aloenxertos de grãos de vários tamanhos, tanto no grupo do anel de reforço quanto no grupo das próteses sem cimento.

Resultados: Em um acompanhamento médio de 82,75 meses, 76% dos quadris não apresentaram complicações, enquanto os demais apresentaram dor, alterações na posição da prótese, luxações pós-operatórias e infecções. A pontuação média pré-operatória do escore de quadril modificado de Harris melhorou em ambos os grupos no último acompanhamento.

Conclusão: O uso de aloenxertos estruturais e aloenxertos de grãos de vários tamanhos para o tratamento de defeitos acetabulares do tipo 3 na substituição total do quadril de revisão mostrou resultados promissores em longo prazo e uma baixa taxa de complicações. Nível de Evidência IV; Série de Casos Retrospectivos.

Keywords: Allografts; Arthroplasty; Hip; Operative; Replacement; Surgical Procedures.

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Conflict of interest statement

All authors declare no potential conflict of interest related to this article.

Figures

Figure 1
Figure 1. Structural allografts was placed into cavity at superoposterior part or the medial wall defect.
Figure 2
Figure 2. Using Various or multiple Grain sizes bone graft.
Figure 3
Figure 3. Grain bone graft were impacted into medial defect.
Figure 4
Figure 4. After gone graft was impacted, reconstruction cage + cemented cup was placed.
Figure 5
Figure 5. Survival of the acetabular implant.
See this image and copyright information in PMC

References

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