Bone restoration after revision hip arthroplasty with femoral bone defects using extensively porous-coated stems with cortical strut allografts

Autor:	Zongke Zhou, Zichuan Ding, Ping Mou, Duan Wang, Tingxian Ling, Kai Zhou
Rok vydání:	2020
Předmět:	Cortical hypertrophy musculoskeletal diseases Adult Male Reoperation medicine.medical_specialty lcsh:Diseases of the musculoskeletal system Cortical strut allografts Arthroplasty Replacement Hip Revision THA Bone remodeling 03 medical and health sciences 0302 clinical medicine Function score lcsh:Orthopedic surgery medicine Humans Orthopedics and Sports Medicine Femur 030212 general & internal medicine Revision hip arthroplasty Aged Retrospective Studies Aged 80 and over 030222 orthopedics Bone Transplantation business.industry Femoral bone defects Extensively porous-coated stems Stress shielding Middle Aged equipment and supplies musculoskeletal system Surgery lcsh:RD701-811 surgical procedures operative Orthopedic surgery Femoral bone Female lcsh:RC925-935 business Research Article
Zdroj:	Journal of Orthopaedic Surgery and Research Journal of Orthopaedic Surgery and Research, Vol 15, Iss 1, Pp 1-9 (2020)
ISSN:	1749-799X
Popis:	BackgroundStress shielding and bone loss of the femur are of great concern after revision total hip arthroplasty (THA) with extensively porous-coated stems, especially in a femur with already bone loss. The femoral bone remodeling patterns after revision THA with femoral bone defects using extensively porous-coated stems with cortical strut allografts remain unclear.MethodsWe retrospectively reviewed 47 patients who underwent revision THA using extensively porous-coated stems combined with cortical strut allografts and 75 patients without allografts. The minimum follow-up was 2 years. Femoral bone remodeling signs, including stress shielding, bone restoration in bone defect area, distal cortical hypertrophy, and femoral width, were compared between patients with and without cortical strut allografts. Clinical outcomes were also compared between two groups.ResultsPatients with cortical strut allografts showed less severe stress shielding (P= 0.01) than patients without allografts. Patients with allografts had more osseous restoration in bone defect area than patients without allografts (63.8% vs 30.7%,P< 0.001). Femoral width was significantly higher in femur with allografts than in femur without allografts at the immediate postoperative stage and latest follow-up (bothP< 0.001). The hip function score, re-revision rate, and complications were comparable between two groups.ConclusionThe application of cortical strut allografts can decrease the severity of stress shielding, augment osseous restoration in bone defect area and improve femoral bone stock after revision THA using extensively porous-coated stems.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d75888b4f8868edb3c7d2ef18880d71c https://pubmed.ncbi.nlm.nih.gov/32460781 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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