Both Acetabular and Femoral Reconstructions With Impaction Bone Grafting in Revision Total Hip Arthroplasty: Case Series and Literature Review

Liang Xiong, MD, PhD; Hui Li, MD, PhD; Xianzhe Huang, MD; Shuo Jie, MD, PhD; Weihong Zhu, MD, PhD; Jiankang Pan, MD, PhD; Xiaoxin Wu, PhD; Xinzhan Mao, MD, PhD

Arthroplasty Today (Dec 2023)

Both Acetabular and Femoral Reconstructions With Impaction Bone Grafting in Revision Total Hip Arthroplasty: Case Series and Literature Review

Liang Xiong, MD, PhD,
Hui Li, MD, PhD,
Xianzhe Huang, MD,
Shuo Jie, MD, PhD,
Weihong Zhu, MD, PhD,
Jiankang Pan, MD, PhD,
Xiaoxin Wu, PhD,
Xinzhan Mao, MD, PhD

Affiliations

Liang Xiong, MD, PhD: Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
Hui Li, MD, PhD: Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
Xianzhe Huang, MD: Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
Shuo Jie, MD, PhD: Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
Weihong Zhu, MD, PhD: Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
Jiankang Pan, MD, PhD: Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
Xiaoxin Wu, PhD: Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
Xinzhan Mao, MD, PhD: Corresponding author. Department of Orthopedics, The Second Xiangya Hospital of Central South University, 139 Renmin Road, Furong District, Changsha, Hunan 410011, China. Tel.: +86 139-7580-6781.; Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China

Journal volume & issue: Vol. 24
p. 101160

Abstract

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Background: Extensive bone loss on femur and acetabulum posed a big challenge to orthopedists in total hip revision surgeries. Impaction bone grafting (IBG) as a valuable bone preservation technique could effectively address this problem. Either IBG revision on the femoral or acetabular side was well studied, while its use on both sides in one operation was not. The aim of this study is to present the outcomes of IBG on both femoral and acetabular sides at first-time hip revision. Methods: We retrospectively reviewed 8 patients (mean follow-up of 5.8 years) undergoing first-time revision with IBG on both acetabular and femoral sides at our institution. The Paprosky classification system was used to classify bone defects. Freeze-dried allografts and cemented prostheses were used in all patients. Postoperative complications and rerevision rates were reported. Results: Five patients presented a Paprosky type IIC acetabular defect, 3 with a type IIIB, IIIA, and IIC defect, respectively. Three patients presented with a type IV femoral defect, 3 with a type IIIB defect, and 2 with a type II defect. Two patients developed complications, while one had an intraoperative femoral fracture and one had delayed wound healing. At the latest follow-up, no patient had rerevisions or operations related to the prosthesis. Conclusions: IBG in combination with cemented prosthesis is a profitable biological reconstruction revision technique that could provide satisfying midterm outcomes. We first propose the use of blood clots mixed with bone grafts for potential bone incorporation enhancement, while its specific effects need to be verified in further studies.

Published in Arthroplasty Today

ISSN: 2352-3441 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Surgery: Orthopedic surgery
Website: https://www.journals.elsevier.com/arthroplasty-today/

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