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.

Acetabular revision with impaction bone grafting and a cemented polyethylene acetabular component: comparison of the Kaplan-Meier analysis to the competing risk analysis in 62 revisions with 25 to 30 years follow-up.

We present the results of 62 consecutive acetabular revisions using impaction bone grafting and a cemented polyethylene acetabular component in 58 patients (13 men and 45 women) after a mean follow-up of 27 years (25 to 30). All patients were prospectively followed. The mean age at revision was 59.

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.

Cemented hip designs are a reasonable option in young patients.

Background: Young patients with degenerative cartilage disease of the hip remain a challenge for the orthopaedic surgeon. Different treatment options are available of which uncemented hips are the most popular owing to long-term concerns about cemented implants. As an alternative, we have used a cemented hip design in combination with bone impaction grafting in patients with acetabular defects.

Acetabular revision with impacted morsellised cancellous bone grafting and a cemented acetabular component: a 20- to 25-year follow-up.

We present an update of the clinical and radiological results of 62 consecutive acetabular revisions using impacted morsellised cancellous bone grafts and a cemented acetabular component in 58 patients, at a mean follow-up of 22.2 years (20 to 25). The Kaplan-Meier survivorship for the acetabular component with revision for any reason as the endpoint was 75% at 20 years (95% confidence interval (CI) 62 to 88) when 16 hips were at risk.

Acetabular revision with impacted morselized cancellous bone graft and a cemented cup in patients with rheumatoid arthritis. A concise follow-up, at eight to nineteen years, of a previous report.

We previously reported our results at a minimum of three years after thirty-five revisions of total hip arthroplasty acetabular components in twenty-eight patients with rheumatoid arthritis. The revisions were performed with use of impacted morselized bone graft and a cemented cup. This update report presents the results at eight to nineteen years after the surgery, which, to our knowledge, is the longest follow-up available in the literature.

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.

[Favourable long-term results from cemented total hip arthroplasty combined with acetabular bone impaction grafting in patients under the age of 50].

Objective: Determination of long-term results of hip replacements in patients who, at the time of operation, were under the age of 50. Procedures whereby an existing acetabulum defect was filled with bone chips that were impacted into a strong layer, after which a cemented total hip prosthesis was implanted.

Design: Descriptive.

Bone graft incorporation after reconstruction of bony defects with impacted morselized bone graft. Histology of animals and patients.

The major problem in revision total hip surgery is the loss of bone stock, which is induced by various factors: the loosening process itself, osteolysis, infection and manipulations during removal of the prosthesis components and the cement. The instability of the implant leads to progressive bone loss and a vicious cycle is initiated in which a combined central and peripheral cavitary segmental defect may develop in the acetabulum. With the technique of impacted bone grafts and cement, it is possible to replace the loss of bone and to repair normal hip mechanics in combination with a standard hip prosthesis, achieving a long-lasting stable reconstruction.

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.

Bone impaction grafting and a cemented cup after acetabular fracture at 3-18 years.

Unlabelled: The outcome of total hip arthroplasty after acetabular fracture is compromised. We studied if the bone impaction grafting technique could provide long-term prosthesis survival in deformed and irregular acetabula. We studied 20 hips in 20 patients (mean age, 53.

Acetabular reconstruction with impaction bone-grafting and a cemented cup in patients younger than fifty years old.

Background: Acetabular bone deficiency can present a challenge during total hip arthroplasty, especially in young patients. The purpose of the present study was to evaluate the long-term clinical and radiographic outcomes of primary and revision acetabular reconstruction with use of an impaction bone-grafting technique and a cemented polyethylene cup in young patients who had preexisting acetabular bone deficiency.

Methods: Forty-two consecutive acetabular reconstructions were performed in thirty-seven patients who were younger than fifty years old (average, 37.

The initial stability of an exeter femoral stem after impaction bone grafting in combination with segmental defect reconstruction.

Bone impaction grafting of the femur is associated with more complications when segmental defects are present. The effect of segmental defect repair on initial stem stability was studied in an in vitro study with fresh-frozen goat femora. A standardized medial segmental defect was reconstructed using a cortical strut or a metal mesh.

Acetabular revision with impacted morsellised cancellous bone grafting and a cemented cup. A 15- to 20-year follow-up.

This study presents the clinical and radiological results of 62 consecutive acetabular revisions in 58 patients, at a mean of 16.5 years follow-up (15 to 20). The Kaplan-Meier survivorship for the cup with end-point revisions for any reason, was 79% at 15 years (95% confidence interval (CI); 67 to 91).

Particle size of bone graft and method of impaction affect initial stability of cemented cups: human cadaveric and synthetic pelvic specimen studies.

We determined the effect of bone graft particle size and impaction technique on the initial stability of cemented acetabular cups. First, acetabular reconstructions were performed in human cadaveric pelvic bones in which type 2 AAOS cavitary defects were created. Reconstructions were made with small bone grafts (average 2 mm) produced by a bone mill or large bone grafts (average 9 mm) produced by hand with a rongeur.

Treatment of femoral head osteonecrosis using bone impaction grafting.

Even in extensive osteonecrosis of the femoral head in younger patients, a femoral head-preserving method is preferable. We developed a new technique using the lateral approach as used in traditional core biopsy; the osteonecrotic lesion was removed and impacted bone grafts were used to regain sphericity and prevent collapse. In this prospective one surgeon study, we included 28 consecutive hips in 27 patients with extensive osteonecrotic lesions (ARCO classification Stage 2 [11 hips], Stage 3 [14 hips]; and Stage 4 [three hips]); 14 hips had preoperative collapse.

Acetabular revision with impacted morselized cancellous bone graft and a cemented cup in patients with rheumatoid arthritis: three to fourteen-year follow-up.

Background: Acetabular revision in patients with rheumatoid arthritis is often difficult because of the poor quality and quantity of the acetabular bone stock. The purpose of this study was to evaluate the midterm clinical and radiographic outcomes of acetabular revision with use of an impaction bone-grafting technique and a cemented polyethylene cup.

Methods: Thirty-five consecutive acetabular revisions were performed with impaction bone-grafting and use of a cemented cup in twenty-eight patients with rheumatoid arthritis.

Rinsing morselized allografts improves bone and tissue ingrowth.

Bone defects in revision hip surgery can be reconstructed with impacted morselized bone grafts. Rinsing these trabecular allografts may enhance graft incorporation by washing out immunogenic factors present in blood, marrow, and fat. However, it has been proposed that impaction of the graft releases biologically active factors, which can provide sufficient activity to stimulate new bone formation.

Incorporation of morselized bone grafts: a study of 24 acetabular biopsy specimens.

Animal studies have shown almost complete incorporation of impacted morselized bone grafts. To determine whether this also is true in humans, 24 acetabular bone biopsy specimens from 21 hips of 20 patients were examined. Biopsy specimens were obtained 3 months to 15 years after acetabular reconstruction in primary and revision total hip arthroplasties in combination with a cemented cup.

Acetabular reconstruction with bone impaction grafting and a cemented cup: 20 years' experience.

Acetabular bone stock loss compromises the outcome in primary and revision total hip arthroplasty. In 1979, a biologic method was introduced with tightly impacted cancellous allografts in combination with a cemented polyethylene cup for acetabular reconstruction. With this technique, it is possible to replace the loss of bone and to repair normal hip mechanics and hip function with a standard implant.

Cemented total hip arthroplasty with impacted morcellized bone-grafts to restore acetabular bone defects in congenital hip dysplasia.

We evaluated the results of 27 acetabular reconstructions in 21 patients with secondary osteoarthritis resulting from congenital dysplasia of the hip in which the acetabular bone defects were restored with impacted morcellized bone-grafts in combination with a cemented cup. At an average follow-up of 7 years, 7 months (range, 5-15 years), 2 hips were revised. One cup was revised after 27 months for sciatic nerve problems; the other hip was revised for aseptic loosening of the cup at 12 years' follow-up.

Time-dependent mechanical properties of HA/TCP particles in relation to morsellized bone grafts for use in impaction grafting.

In reconstructive surgery human bone defects are sometimes filled with the use of the impaction bone grafting technique. Currently different types of biomaterial particles are being developed as bone-substitute materials. Before these biomaterials can be applied their mechanical and biological behavior should be characterized.