Decreased migration with locally administered bisphosphonate in cemented cup revisions using impaction bone grafting technique
| Autor: | Ola Belfrage, Vasileios Zampelis, Gunnar Flivik, Magnus Tägil, Martin Sundberg |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Orthopedic surgery
Hip surgery 030222 orthopedics medicine.medical_specialty business.industry Impaction Bone stock medicine.medical_treatment Dentistry General Medicine Bisphosphonate Bone grafting Surgery 03 medical and health sciences 0302 clinical medicine medicine Orthopedics and Sports Medicine 030212 general & internal medicine business RD701-811 |
| Zdroj: | Acta Orthopaedica, Vol 89, Iss 1, Pp 17-22 (2018) |
| ISSN: | 1745-3682 1745-3674 |
| DOI: | 10.1080/17453674.2017.1371468 |
| Popis: | Background and purpose — Impaction bone grafting (IBG) in revision hip surgery is an established method in restoring bone stock deficiencies. We hypothesized that local treatment of the morsellized allograft with a bisphosphonate in cemented revision would, in addition to increased bone density, also reduce the early migration of the cup as measured by radiostereometry (RSA). Patients and methods — 20 patients with aseptic cup loosening underwent revision using the IBG technique. The patients were randomized to either clodronate (10 patients) or saline (10 patients, control group) as local adjunct to the morsellized bone. The outcome was evaluated by dual-energy X-ray absorptiometry (DXA) during the first year regarding periacetabular bone density and with radiostereometric analysis (RSA) for the first 2 years regarding cup migration. Results — 2 patients were lost to follow-up: 9 patients remained in the clodronate and 9 in the control group. Less proximal migration was found in the clodronate group compared with the controls, measured both over time (mixed-models analysis, p = 0.02) as well as at the specified time points up to 2 years (0.22 mm and 0.59 mm respectively, p = 0.02). Both groups seemed to have stabilized at 1 year. We found similar bone mineral density measured by DXA, and similar RSA migration in the other directions. No cups were re-revised. Interpretation — Local treatment of the allograft bone with clodronate reduced early proximal migration of the revised cup but without any measurable difference in periacetabular bone density. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|