Filling Bone Defects after Hip Arthroplasty Revision Using Hydroxyapatite/β-tricalcium Phosphate: A Case Report with Long-term Result.

Introduction: The increasing number of primary total hip replacements means that there is an increased need for hip arthroplasty revisions. The periprosthetic fractures which cause bone defects can occur during removal of the femoral component and healing of these fractures can be delayed. In femoral bone defects during revisions, there are no metal augments for filling these defects.

Case Report: Fifty-nine-year-old female presented with infected loosening of the left hip non-cemented endoprosthesis 5 years after surgery. The patient underwent removal of endoprosthesis. In 2 months, re-implantation of non-cemented endoprosthesis was performed and biphasic calcium phosphate (BCP) ceramic granules with hydroxyapatite/β-tricalcium phosphate (HAp/β-TCP) were implanted in the femoral bone defects. Eleven months following the arthroplasty patient had periprosthetic fracture of the distal third of the left femur. The osteosynthesis was performed and BCP ceramic granules with HAp/β-TCP were used to fill the bone defect. Long-term follow-up showed very good functional outcome and bone defect healing.

Conclusion: The BCP ceramic granules with HAp/β-TCP material adjusted to the bone defect anatomy, showed effective femoral bone defect and periprosthetic fracture healing in a patient with hip arthroplasty revision and periprosthetic fracture.