Acetabular Reconstructions with Impaction Bone-Grafting and a Cemented Cup in Patients Younger Than 50 Years of Age: A Concise Follow-up, at 27 to 35 Years, of a Previous Report.

Unlabelled: We present an update of 19 acetabular reconstructions, performed with a cemented total hip arthroplasty and impaction bone-grafting, in situ at the time of our previous report. At a mean follow-up of 30 years (range, 27 to 35 years), no additional patients were lost to follow-up. Two patients (3 reconstructions) died for reasons unrelated to the hip surgery.

Satisfying Results of Primary Hip Arthroplasty in Patients With Hip Dysplasia at a Mean Followup of 20 Years.

Background: Developmental dysplasia of the hip (DDH) is a common cause of secondary osteoarthritis (OA) in younger patients, and when end-stage OA develops, a THA can provide a solution. Different options have been developed to reconstruct these defects, one of which is impaction bone grafting combined with a cemented cup. To determine the true value of a specific technique, it is important to evaluate patients at a long-term followup.

Predictors of unsuccessful outcome in cemented femoral revisions using bone impaction grafting; Cox regression analysis of 208 cases.

Introduction: Despite improvements in the technique of femoral impaction bone grafting, reconstruction failures still can occur. Therefore, the aim of our study was to determine risk factors for the endpoint re-revision for any reason.

Methods: We used prospectively collected demographic, clinical and surgical data of all 202 patients who underwent 208 femoral revisions using the X-change Femoral Revision System (Stryker-Howmedica), fresh-frozen morcellised allograft and a cemented polished Exeter stem in our department from 1991 to 2007.

Medium-term follow-up of 92 femoral component revisions using a third-generation cementing technique.

Background And Purpose: Very little has been published on the outcome of femoral cemented revisions using a third-generation cementing technique. We report the medium-term outcome of a consecutive series of patients treated in this way.

Patients And Methods: This study included 92 consecutive cemented femoral revisions performed in our department with a third-generation cementing technique and without instrumented bone impaction grafting between 1996 and 2007.

Satisfying outcomes scores and survivorship achieved with impaction grafting for revision THA in young patients.

Background: The increasing number of total hip arthroplasties (THAs) performed in younger patients will inevitably generate larger numbers of revision procedures for this specific group of patients. Unfortunately, no satisfying revision method with acceptable survivorship 10 years after revision has been described for these patients so far.

Questions/purposes: The purposes of this study were to (1) analyze the clinical outcome; (2) complication rate; (3) survivorship; and (4) radiographic outcome of cemented revision THA performed with impaction bone grafting (IBG) on both the acetabular and femoral sides in one surgery in patients younger than 55 years old.

Cemented total hip arthroplasty revisions in patients of eighty years and older.

Purpose: It is often a difficult decision whether it is safe to perform revision hip surgery in a patient of 80 years and older. Therefore we evaluated the results of cemented revisions in these elderly patients.

Methods: Clinical data, radiographs and complications of 49 consecutive cup and/or stem revisions in 48 patients were prospectively collected.

Acetabular re-revision with impaction bone grafting and a cemented polyethylene cup; a biological option for successive reconstructions.

Introduction: For the revision of failed acetabular components impaction bone grafting (IBG) with a cemented cup is a well known technique. Claims have been made that this is a biological reconstruction technique, restoring the bone stock loss and thereby facilitating future revisions. However, there are no scientific data proving this claim.

Cement-in-cement femoral revisions using a specially designed polished short revision stem; 24 consecutive stems followed for five to seven years.

Femoral cement-in-cement revisions are attractive if the cement bone mantle is well fixed. However, most available cemented stems are too long to fit in the existing cement mantle. We evaluated the medium-term outcomes of the 125 mm short tapered polished stem (Exeter Short Revision Stem (SRS)) with a 44 mm offset specifically designed to facilitate cement-in-cement revisions of hip arthroplasties.

Prosthetic fitting in a patient with a transtibial amputation due to a congenital vascular malformation of the right leg.

Background: The problems of prescribing a prosthesis for a young girl with severe congenital vascular malformation deformity leading to a transtibial amputation.

Case Description And Methods: Due to the high risk of recurrent bleeding and limitations regarding full weight bearing of the stump, a normal socket fitting process was not possible. Using a multidisciplinary approach, a prosthesis was designed to enable full weight bearing in a flexed knee position with ischial tuberosity support to prevent full weight bearing on the tibial part of the stump.

Surgical technique: Results of stabilization of sternoclavicular joint luxations using a polydioxanone envelope plasty.

Background: Surgical treatment options for sternoclavicular joint luxations described in the literature are numerous, although all have limitations. Therefore, there is no favorable surgical treatment for sternoclavicular luxations when nonoperative treatment has failed.

Description Of Technique: We developed the polydioxanone (PDS) envelope plasty, a modification of the figure-of-eight technique, using a PDS ligament.

Long-term results of cemented total hip arthroplasty in patients younger than 30 years and the outcome of subsequent revisions.

Background: The number of total hip arthroplasties in patients under 30 years is increasing over the years. Almost all of them will face at least one or more future revisions in their life. Therefore, the implant used should have a high survival rate, and needs to be easily revisable resulting in a low re-revision rate.

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.

We previously reported our results for thirty-three consecutive femoral component revisions with impaction bone-grafting, performed with the X-change femoral revision system and a cemented polished Exeter stem, at a minimum of eight years of follow-up. The present updated study shows the results after fifteen to twenty years. One stem was revised again for mechanical reasons during a rerevision of an acetabular cup.

Acetabular reconstruction with impaction bone-grafting and a cemented cup in patients younger than fifty years old: a concise follow-up, at twenty to twenty-eight years, of a previous report.

In a previous report, we presented our results of forty-two acetabular reconstructions, performed with use of impaction bone-grafting and a cemented polyethylene cup, in thirty-seven patients who were younger than fifty years and had a minimum of fifteen years of follow-up. The present update study shows the results after twenty to twenty-eight years. Eight additional cups had to be revised--four because of aseptic loosening, three because of wear, and one during a revision of the stem.

Revisions of extensive acetabular defects with impaction grafting and a cement cup.

Background: Loosening of acetabular components often leads to bony defects. Management of extensive acetabular bone loss in hip revision arthroplasty can be a tremendous challenge.

Questions/purposes: We asked whether a reconstruction with impacted bone grafts will provide a durable and pain-free function in extensive acetabular defects.

[Total hip arthroplasty in patients under 40 years of age and, if indicated, reconstruction of acetabular defects with bone impaction grafting].

Objective: To determine the long-term results of primary cemented total hip arthroplasty in patients under the age of 40. In cases of acetabular defects, initial reconstruction with bone impaction grafting was performed.

Design: Cohort analysis.

Good results with cemented total hip arthroplasty in patients between 40 and 50 years of age.

Background And Purpose: Total hip arthroplasties in young patients have lower long-term survival rates than in older patients. We evaluated the use of a unique treatment protocol in patients aged between 40 and 50 years. In all cases we used a cemented THA, and for acetabular deficiencies we also used impacted bone grafts together with a cemented cup.

Cemented polyethylene cups in patients younger than 40 years.

Unlabelled: Although uncemented cup implants frequently are used in young patients, we believe long-term survival rates of cups in these patients are somewhat disappointing, and therefore we have continued to use cemented cups in primary THA, even in young patients. However, in cases of acetabular bone stock defects, we also use bone impaction grafting. We prospectively followed 130 patients with 175 cemented cups; no patients were lost to followup.

Total hip arthroplasty after failed treatment for osteonecrosis of the femoral head.

This article presents results for total hip arthroplasty after failed transtrochanteric rotational osteotomy according to Sugioka and after failed bone impaction grafting, both initially performed for osteonecrosis of the femoral head. After a minimal follow-up of 2 years, 33 hips were studied. In total hip arthroplasty after failed osteotomy, when compared with total hip arthroplasty after failed bone impaction grafting, clinical and radiologic outcome was less favorable, more complications were observed, and there was a higher revision rate for a technically more demanding procedure.

Favorable survival of acetabular reconstruction with bone impaction grafting in dysplastic hips.

Unlabelled: Acetabular bone loss hampers implantation of a total hip arthroplasty in patients with developmental dysplasia of the hip. The bone impaction grafting technique in combination with a cemented total hip can restore the bone stock in these patients, but do these reconstructions yield satisfying long-term results? We used this technique in 28 hips (22 consecutive patients). The degree of dislocation was graded preoperatively as Crowe I in five hips, Crowe II in eight hips, Crowe III in nine hips, and Crowe IV in four hips.

No effect of bone morphogenetic protein-7 (OP-1) on the incorporation of impacted bone grafts in a realistic acetabular model.

Bone morphogenetic proteins (BMPs) accelerate bone repair in experimental and clinical conditions. Impacted Morsellized Cancellous Bone grafts (MCB) are successfully used to reconstruct bone defects after failed hip implants. The main question in this study was if BMP-7 (OP-1) mixed with MCB could accelerate the incorporation of MCB and prevents the formation of a soft tissue interface after remodeling of the MCB.

Impacted bone and calcium phosphate cement for repair of femoral head defects: a pilot study.

Bone impaction grafting has been advocated for reconstruction of femoral head osteonecrosis. However, bone grafts do not prevent the progression of collapse and subsequent disabling osteoarthritis in late-stage osteonecrosis. We hypothesized reconstruction of large subchondral defects with a mix of impacted morsellized cancellous bone grafts and calcium phosphate cement would afford mechanical stability allowing remodeling into new bone without femoral head collapse.

Bone impaction grafting for corticosteroid-associated osteonecrosis of the knee.

Background: Osteonecrosis of the distal portion of the femur produces a segment of dead bone in the weight-bearing portion of the femoral condyle, frequently associated with subchondral fracture and collapse and eventually resulting in secondary osteoarthritis. Treatment of these late stages of osteonecrosis in the knee can be problematic. The purpose of the present study was to evaluate a new surgical technique in which the subchondral osteonecrotic lesion is removed.

Femoral component revision with use of impaction bone-grafting and a cemented polished stem. Surgical technique.

Background: The purpose of this study was to evaluate the clinical and radiographic outcomes of revision of the femoral component of a hip arthroplasty with use of an impaction bone-grafting technique and a cemented polished stem.

Methods: Thirty-three consecutive femoral reconstructions that were performed between March 1991 and February 1996 with use of the X-change femoral revision system, fresh-frozen morselized allograft, and a cemented polished Exeter stem were followed prospectively. Femoral bone stock defects were classified according to the Endoklinik classification.

Femoral component revision with use of impaction bone-grafting and a cemented polished stem.

Background: The purpose of this study was to evaluate the clinical and radiographic outcomes of revision of the femoral component of a hip arthroplasty with use of an impaction bone-grafting technique and a cemented polished stem.

Methods: Thirty-three consecutive femoral reconstructions that were performed between March 1991 and February 1996 with use of the X-change femoral revision system, fresh-frozen morselized allograft, and a cemented polished Exeter stem were followed prospectively. Femoral bone stock defects were classified according to the Endoklinik classification.

No negative effects of bone impaction grafting with bone and ceramic mixtures.

Reconstructing large loaded bone defects with ceramic bone graft extenders is tempting considering the expected future donor bone shortage. However, whether there are negative effects is unknown. Standardized large defects in the acetabulum of goats were created and subsequently reconstructed with metal mesh and impacted morselized cancellous bone grafts or a 50/50% volume mixture of tricalcium phosphate-hydroxyapatite granules and morselized cancellous bone grafts using the bone impaction grafting technique.