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Acetabular Cup Revision Arthroplasty Using Morselized Impaction Allograft

김태호|이중명
대한고관절학회 (The Korean Hip Society)|2018.06|Hip and Pelvis|제30권 제2호|pp. 65-77|DOI 10.5371/hp.2018.30.2.65

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참고문헌

키워드

RevisionAllograftHip arthroplastyAcetabulum

초록

The rate of acetabular cup revision arthroplasty is gradually rising along with an increased risk of osteolysis and prosthesis loosening over time and an increase in life expectancy. The goals of revision total hip arthroplasty are: i) implant stability through reconstruction of large bone defects, ii) restoration of range of motion and biomechanics of the hip joint, and iii) normalization of uneven limb lengths. In acetabular cup revision arthroplasty, stable fixation of acetabular components is difficult in the presence of severe bone loss (e.g., evidence suggests that it is challenging to achieve satisfactory results in cases of Paprosky type 3 or higher bone defects using conventional techniques). The author of this study performed acetabular revision to manage patients with large areas of defective bones by filling in with morselized impaction allografts. These allografts were irradiated frozen-stored femoral heads acquired from a tissue bank, and were applied to areas of an acetabular bone defect followed by insertion of a cementless cup. When this procedure was insufficient to obtain primary fixation, a tri-cortical or structural allograft using a femoral head was carried out. Structural stability and bone incorporation were confirmed via long-term follow-up. This study aims to review conventional surgical techniques and verify the utility of surgical procedures by analyzing the author’s surgical methods and discussing case reports.

Abstract

The rate of acetabular cup revision arthroplasty is gradually rising along with an increased risk of osteolysis and prosthesis loosening over time and an increase in life expectancy. The goals of revision total hip arthroplasty are: i) implant stability through reconstruction of large bone defects, ii) restoration of range of motion and biomechanics of the hip joint, and iii) normalization of uneven limb lengths. In acetabular cup revision arthroplasty, stable fixation of acetabular components is difficult in the presence of severe bone loss (e.g., evidence suggests that it is challenging to achieve satisfactory results in cases of Paprosky type 3 or higher bone defects using conventional techniques). The author of this study performed acetabular revision to manage patients with large areas of defective bones by filling in with morselized impaction allografts. These allografts were irradiated frozen-stored femoral heads acquired from a tissue bank, and were applied to areas of an acetabular bone defect followed by insertion of a cementless cup. When this procedure was insufficient to obtain primary fixation, a tri-cortical or structural allograft using a femoral head was carried out. Structural stability and bone incorporation were confirmed via long-term follow-up. This study aims to review conventional surgical techniques and verify the utility of surgical procedures by analyzing the author’s surgical methods and discussing case reports.

참고문헌 (57)

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관련 논문AI추천

Acetabular Reconstruction in Total Hip Arthroplasty손원용, 최정우, Siva Swaminathan Santhanam대한고관절학회 · Hip and Pelvis2016 · 제28권 제1호Acetabular Cup Revision김영호대한고관절학회 · Hip and Pelvis2017 · 제29권 제3호A Review and Description of Acetabular Impaction Bone Grafting: Updating the Traditional TechniqueAun H. Mirza, Shahzad Sadiq대한고관절학회 · Hip and Pelvis2021 · 제33권 제4호Revision Total Hip Arthroplasty Using Tantalum Augment in Patients with Paprosky III or IV Acetabular Bone Defects: A Minimum 2-year Follow Up Study정민, 김형주, 문영완, 박윤수, 임승재대한고관절학회 · Hip and Pelvis2016 · 제28권 제2호Management of Severe Bone Defects in Femoral Revision following Total Hip ArthroplastyLi Cao, Yicheng Li대한고관절학회 · Hip and Pelvis2024 · 제36권 제2호Acetabular Defect Reconstruction with Trabecular Metal Augments: Study with Minimum One-year Follow-up김현곤, 손원용, 오전근, Chirayu Dwivedi, Sandeep Gokhale대한고관절학회 · Hip and Pelvis2017 · 제29권 제3호

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