• J Arthroplasty · Mar 2017

    Favorable Early Results of Impaction Bone Grafting With Reinforcement Mesh for the Treatment of Paprosky 3B Acetabular Defects.

    • Bradford S Waddell, Friedrich Boettner, and Gonzalez Della Valle Alejandro A Adult Reconstruction and Joint Replacement Division, Hospital for Special Surgery, New York, New York..
    • Adult Reconstruction and Joint Replacement Division, Hospital for Special Surgery, New York, New York.
    • J Arthroplasty. 2017 Mar 1; 32 (3): 919-923.

    BackgroundWe present the early institutional experience with the use of impaction bone grafting, mesh augmentation, and cement fixation of an all-polyethylene cup for the treatment of Paprosky 3B acetabular defects during revision total hip arthroplasty.MethodsBetween 2005 and 2014, 21 patients (9 men, 12 women) with Paprosky 3B acetabular defects who underwent revision total hip arthroplasty using this technique were reviewed clinically and radiographically. Average age and body mass index were 72.4 (range, 48-91) years and 24.5 (range, 18.9-31) kg/m2, respectively. All patients underwent revision for aseptic loosening. Surgical technique included the use of a peripheral mesh to contain the defect, followed by impaction of morselized fresh-frozen bone graft and cement fixation of a polyethylene cup.ResultsComplications occurred in 6 patients (29%) including limp (2), sciatic nerve palsy that resolved (1), limb length discrepancy (1), and greater trochanteric fracture (1). After an average follow-up of 47 months (range, 13-128 months), the average Hospital for Special Surgery hip score was 35.5 (range, 20-40). Radiographic assessment revealed cephalad cup migration of 2.29 mm (range, 0-20 mm) and medial migration of 1.57 mm (range, 0-6 mm). One patient has radiographic loosening and no symptoms 120 months postoperatively. No patient returned to the operating room for a related reason or is scheduled to undergo acetabular re-revision surgery.ConclusionImpaction bone grafting is a reliable technique for the treatment of Paprosky 3B acetabular defects. It restores bone stock like no other available for addressing these defects. Longer follow-up is required to assess potential deterioration of fixation.Copyright © 2016 Elsevier Inc. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…