Reconstruction of Acetabular and Femoral Bone Defects With Impaction Bone Grafting in Revision Hip Arthroplasty: A Case Report
- Authors: Golnik V.N.1, Peleganchuk V.A.1, Batrak Y.M.1, Pavlov V.V.2, Kirilova I.A.2
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Affiliations:
- Federal Center for Traumatology, Orthopedics and Endoprosthetics
- Novosibirsk Research Institute of Traumatology and Orthopedics n.a. Ya.L. Tsivyan
- Issue: Vol 29, No 3 (2023)
- Pages: 102-109
- Section: Case Reports
- URL: https://journal-vniispk.ru/2311-2905/article/view/255269
- DOI: https://doi.org/10.17816/2311-2905-8008
- ID: 255269
Cite item
Abstract
Background. For many years, the main reasons for revision surgeries after hip arthroplasty remain aseptic loosening and osteolysis, which lead to formation of bone defects of various size and localization. Given the relatively young age of patients undergoing revision, the methods of biological restoration of the bone tissue, such as impaction bone grafting (IBG), are of particular interest.
Aim of the report — to demonstrate the delayed outcome of impaction bone grafting using compacted morselized bone allograft.
Case presentation. Complicated clinical case of a 62-year-old patient with Paprosky type IIA bone deficiency in the acetabulum and Paprosky type II bone deficiency in the proximal femur with aseptic loosening of the acetabular and femoral components of the hip prosthesis is presented. During revision arthroplasty with cemented components, IBG of the acetabulum and femur was performed with a reconstructive mesh augmentation of the acetabulum using Stryker X-Change technology. Bone allograft prepared with the use of heat disinfection method served as an osteoplastic material. Follow-up period was 4 years. Control X-rays demonstrate restoration of the center of rotation of the hip, presence of bone masses in the areas of pelvic and femoral bone defects, absence of osteoplastic material resorption and migration of implants during the follow-up period. Clinical assessment shows an improvement of the Harris Hip Score from 34 to 85 points.
Conclusion. Obtained results showed the efficacy of impaction bone grafting with the bone allograft prepared with the use of heat disinfection method in the mid-term period.
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##article.viewOnOriginalSite##About the authors
Vadim N. Golnik
Federal Center for Traumatology, Orthopedics and Endoprosthetics
Email: vgolnik@mail.ru
ORCID iD: 0000-0002-5047-2060
зав. отделением травматологии и ортопедии №2
Russian Federation, BarnaulVladimir A. Peleganchuk
Federal Center for Traumatology, Orthopedics and Endoprosthetics
Email: 297501@mail.ru
ORCID iD: 0000-0002-2386-4421
Dr. Sci. (Med.)
Russian Federation, BarnaulYuriy M. Batrak
Federal Center for Traumatology, Orthopedics and Endoprosthetics
Email: 297501@mail.ru
ORCID iD: 0000-0003-0489-1480
Cand. Sci. (Med.)
Russian Federation, BarnaulVitaliy V. Pavlov
Novosibirsk Research Institute of Traumatology and Orthopedics n.a. Ya.L. Tsivyan
Email: pavlovdoc@mail.ru
ORCID iD: 0000-0002-8997-7330
Dr. Sci. (Med.)
Russian Federation, 17, Frunze st., Novosibirsk, 630091Irina A. Kirilova
Novosibirsk Research Institute of Traumatology and Orthopedics n.a. Ya.L. Tsivyan
Author for correspondence.
Email: irinakirilova71@mail.ru
ORCID iD: 0000-0003-1911-9741
Dr. Sci. (Med.), Deputy Director for Research
Russian Federation, 17, Frunze st., Novosibirsk, 630091References
- Gwam C.U., Mistry J.B., Mohamed N.S., Thomas M., Bigart K.C., Mont M.A. et al. Current epidemiology of revision total hip arthroplasty in the United States: National Inpatient Sample 2009 to 2013. J Arthroplasty. 2017;32(7):2088-2092. doi: 10.1016/j.arth.2017.02.046.
- Kurtz S.M., Lau E.C., Ong K.L., Adler E.M., Kolisek F.R., Manley M.T. Which clinical and patient factors influence the national economic burden of hospital readmissions after total joint arthroplasty? Clin Orthop Relat Res. 2017;475(12):2926-2937. doi: 10.1007/s11999-017-5244-6.
- Patel A., Pavlou G., Mújica-Mota R.E., Toms A.D. The epidemiology of revision total knee and hip arthroplasty in England and Wales: a comparative analysis with projections for the United States. A study using the National Joint Registry dataset. Bone Joint J. 2015;97-B(8):1076-1081. doi: 10.1302/0301-620X.97B8.35170.
- Jafari S.M., Coyle C., Mortazavi S.M., Sharkey P.F., Parvizi J. Revision hip arthroplasty: infection is the most common cause of failure. Clin Orthop Relat Res. 2010;468(8):2046-2051. doi: 10.1007/s11999-010-1251-6.
- Kummerant J., Wirries N., Derksen A., Budde S., Windhagen H., Floerkemeier T. The etiology of revision total hip arthroplasty: current trends in a retrospective survey of 3450 cases. Arch Orthop Trauma Surg. 2020;140(9):1265-1273. doi: 10.1007/s00402-020-03514-3.
- Kerzner B., Kunze K.N., O’Sullivan M.B., Pandher K., Levine B.R. An epidemiological analysis of revision aetiologies in total hip arthroplasty at a single high-volume centre. Bone Jt Open. 2021;2(1):16-21. doi: 10.1302/2633-1462.21.BJO-2020-0171.R1.
- Руководство по хирургии тазобедренного сустава. Под ред. Р.М. Тихилова, И.И. Шубнякова. Санкт-Петербург: РНИИТО имени Р.Р. Вредена; 2014. Т. 1. с. 221-256.
- Hip Surgery Guide. Ed. by R.M. Tikhilov, I.I. Shubnyakov. Saint Petersburg: RNIITO im. R.R. Vredena; 2014. Vol. I. p. 221-256. (In Russian).
- Тихилов Р.М., Шубняков И.И., Денисов А.О. Классификации дефектов вертлужной впадины: дают ли они объективную картину сложности ревизионного эндопротезирования тазо- бедренного сустава? (критический обзор литературы и собственных наблюдений). Травматология и ортопедия России. 2019;25(1):122-141. doi: 10.21823/2311-2905-2019-25-1-122-141.
- Tikhilov R.M., Shubnyakov I.I., Denisov A.O. Classifications of Acetabular Defects: Do They Provide an Objective Evidence for Complexity of Revision Hip Joint Arthroplasty? (Critical Literature Review and Own Cases). Traumatology and Orthopedics of Russia. 2019;25(1): 122-141. doi: 10.21823/2311-2905-2019-25-1-122-141.
- Colo E., Rijnen W.H., Schreurs B.W. The biological approach in acetabular revision surgery: impaction bone grafting and a cemented cup. Hip Int. 2015;25(4): 361-367. doi: 10.5301/hipint.5000267.
- Paprosky W.G., Perona P.G., lawrence j.M. Acetabular defect classification and surgical reconstruction in revision arthroplasty. a 6-year follow-up evaluation. J Arthroplasty. 1994;9(1):33-44. doi: 10.1016/0883-5403(94)90135-x.
- Valle C.J., Paprosky W.G. Classification and an algorithmic approach to the reconstruction of femoral deficiency in revision total hip arthroplasty. J Bone Joint Surg Am. 2003;85-A Suppl 4:1-6. doi: 10.2106/00004623-200300004-00001.
- Brooker A.F., Bowennan J.W., Robinson R.A., Riley L.H. Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg Am. 1973;55(8):1629-132.
- D’Antonio J.A., Capello W.N., Borden L.S., Bargar W.L., Bierbaum B.F., Boettcher W.G. et al. Classification and management of acetabular abnormalities in total hip arthroplasty. Clin Orthop Relat Res. 1989;(243):126-137.
- García-Cimbrelo E., García-Rey E. Bone defect determines acetabular revision surgery. Hip Int. 2014; 24 Suppl 10:S33-S36. doi: 10.5301/hipint.5000162.
- Tikhilov R.M., Dzhavadov A.A., Kovalenko A.N., Bilyk S.S., Denisov A.O., Shubnyakov I.I. Standard Versus Custom-Made Acetabular Implants in Revision Total Hip Arthroplasty. J Arthroplasty. 2022;37(1):119-125. doi: 10.1016/j.arth.2021.09.003.
- van Egmond N., De Kam D.C., Gardeniers J.W., Schreurs B.W. Revisions of extensive acetabular defects with impaction grafting and a cement cup. Clin Orthop Relat Res. 2011;469(2):562-573. doi: 10.1007/s11999-010-1618-8.
- Ling R.S., Timperley A.J., Linder L. Histology of cancellous impaction grafting in the femur. A case report. J Bone Joint Surg Br. 1993;75(5):693-696. doi: 10.1302/0301-620X.75B5.8376422.
- Linder L. Cancellous impaction grafting in the human femur: histological and radiographic observations in 6 autopsy femurs and 8 biopsies. Acta Orthop Scand. 2000;71(6):543-552. doi: 10.1080/000164700317362154.
- van der Donk S., Buma P., Verdonschot N., Schreurs B.W. Effect of load on the early incorporation of impacted morsellized allografts. Biomaterials. 2002;23(1):297-303. doi: 10.1016/s0142-9612(01)00108-9.
- Wang J.S., Tägil M., Aspenberg P. Load-bearing increases new bone formation in impacted and morselized allografts. Clin Orthop Relat Res. 2000;(378):274-281. doi: 10.1097/00003086-200009000-00038.
- Waddell B.S., Della Valle A.G. Reconstruction of non-contained acetabular defects with impaction grafting, a reinforcement mesh and a cemented polyethylene acetabular component. Bone Joint J. 2017;99-B(1 Supple A): 25-30. doi: 10.1302/0301-620X.99B1.BJJ-2016-0322.R1.
- Garcia-Cimbrelo E., Cruz-Pardos A., Garcia-Rey E., Ortega-Chamarro J. The survival and fate of acetabular reconstruction with impaction grafting for large defects. Clin Orthop Relat Res. 2010;468(12):3304-3313. doi: 10.1007/s11999-010-1395-4.
- Comba F., Buttaro M., Pusso R., Piccaluga F. Acetabular revision surgery with impacted bone allografts and cemented cups in patients younger than 55 years. Int Orthop. 2009;33(3):611-616. doi: 10.1007/s00264-007-0503-x.
- Busch V.J., Gardeniers J.W., Verdonschot N., Slooff T.J., Schreurs B.W. 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. J Bone Joint Surg Am. 2011;93(4):367-371. doi: 10.2106/JBJS.I.01532.
- Schreurs B.W., Luttjeboer J., Thien T.M., de Waal Malefijt M.C., Buma P., Veth R.P. et al. 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. J Bone Joint Surg Am. 2009;91(3):646-651. doi: 10.2106/JBJS.G.01701.
- Iwase T., Ito T., Morita D. Massive bone defect compromises postoperative cup survivorship of acetabular revision hip arthroplasty with impaction bone grafting. J Arthroplasty. 2014;29(12):2424-2429. doi: 10.1016/j.arth.2014.04.001.
- Pierannunzii L., Zagra L. Bone grafts, bone graft extenders, substitutes and enhancers for acetabular reconstruction in revision total hip arthroplasty. EFORT Open Rev. 2016;1(12):431-439. doi: 10.1302/2058-5241.160025.
- Fölsch C., Dharma J., Fonseca Ulloa C.A., Lips K.S., Rickert M., Pruss A. et al. Influence of thermodisinfection on microstructure of human femoral heads: duration of heat exposition and compressive strength. Cell Tissue Bank. 2020;21(3):457-468. doi: 10.1007/s10561-020-09832-5.
- Анастасиева Е.А., Черданцева Л.А., Толстикова Т.Г., Кирилова И.А. Использование депротеинизированной костной ткани в качестве матрицы тканеинженерной конструкции: экспериментальное исследование. Травматология и ортопедия России. 2023;29(1):46-59. doi: 10.17816/2311-2905-2016.
- Anastasieva E.A., Cherdantseva L.A., Tolstikova T.G., Kirilova I.A. Deproteinized Bone Tissue as a Matrix for Tissue-Engineered Construction: Experimental Study. Traumatology and Orthopedics of Russia. 2023;29(1): 46-59. (In Russian). doi: 10.17816/2311-2905-2016.
- Voor M.J., Nawab A., Malkani A.L., Ullrich C.R. Mechanical properties of compacted morselized cancellous bone graft using one-dimensional consolidation testing. J Biomech. 2000;33(12):1683-1688. doi: 10.1016/s0021-9290(00)00156-1.
- Pratt J.N., Griffon D.J., Dunlop D.G., Smith N., Howie C.R. Impaction grafting with morsellised allograft and tricalcium phosphate-hydroxyapatite: incorporation within ovine metaphyseal bone defects. Biomaterials. 2002;23(16):3309-3317. doi: 10.1016/s0142-9612(02)00018-2.
- Verdonschot N., Schreurs B., van Unen J., Slooff T., Huiskes R. Cup stability after acetabulum reconstruction with morsellized grafts is less surgical dependent when larger grafts are used. Trans Orthop Res Soc. 1999;24:867.
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