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Post-operative hip centre restoration and migration after impaction bone grafting in revision and complex primary hip arthroplasty

  • Original Article • HIP - ARTHROPLASTY
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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Introduction/objectives

Although impaction grafting proved efficacy in the reconstruction of acetabular defects in primary and revision hip arthroplasty, its role in large segmental defects is still debatable. Our objective is to determine hip centre restoration and last follow-up migration after acetabular reconstruction with impaction grafting in different types of acetabular defects.

Methods

This is a single-centre retrospective radiographic study of (107) total hip arthroplasty (42 primary and 65 revision) in (104) patients using impaction grafting. The available radiographs were examined for normal, preoperative, immediate postoperative, and last follow-up vertical (Y) and horizontal (X) hip centre. Maximum acetabular defect distance (MADD), presence, and size of the mesh were recorded.

Results

In type I and II AAOS defects, the post-operative hip centre was not significantly different from the normal hip centre on the contralateral healthy side. In type III defects, there was a significant variation between the normal hip centre and the post-operative hip centre (P value 0.034 and 0.001 for Y and X, respectively). At 44-month follow-up of 36 hips, 31 (86%) hips migrated. The mean migration ± SD was 5.72 ± 3.7, 2, 4.15 ± 1.2, and 11.26 ± 3.9 mm for types I, II, and III, respectively (P value 0.211). Hips with MADD > 15 mm, especially with large mesh sizes migrate significantly more (P value = 0.042, 0.037, and 0.039, respectively).

Conclusion

Hip centre restoration was better, and migration was less for type I and II AAOS rather than for type III. Other options for reconstruction should be considered.

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References

  1. Watts CD, Abdel MP, Hanssen AD, Pagnano MW (2016) Anatomic hip center decreases aseptic loosening rates after total hip arthroplasty with cement in patients with Crowe type-II dysplasia: a concise follow-up report at a mean of thirty-six years. J Bone Joint Surg Am 98(11):910–915. https://doi.org/10.2106/jbjs.15.00902

    Article  PubMed  Google Scholar 

  2. Kaku N, Tabata T, Tsumura H (2015) Influence of cup-center-edge angle on micro-motion at the interface between the cup and host bone in cementless total hip arthroplasty: three-dimensional finite element analysis. Eur J Orthop Surg Traumatol Orthop Traumatol 25(8):1271–1277. https://doi.org/10.1007/s00590-015-1697-z

    Article  Google Scholar 

  3. Slooff TJ, Huiskes R, van Horn J, Lemmens AJ (1984) Bone grafting in total hip replacement for acetabular protrusion. Acta Orthop Scand 55(6):593–596

    Article  CAS  Google Scholar 

  4. Schreurs BW, Thien TM, de Waal Malefijt MC, Buma P, Veth RP, Slooff TJ (2003) Acetabular revision with impacted morselized cancellous bone graft and a cemented cup in patients with rheumatoid arthritis: three to fourteen-year follow-up. J Bone Joint Surg Am 85-A(4):647–652

    Article  Google Scholar 

  5. Schreurs BW, Keurentjes JC, Gardeniers JW, Verdonschot N, Slooff TJ, Veth RP (2009) Acetabular revision with impacted morsellised cancellous bone grafting and a cemented acetabular component: a 20- to 25-year follow-up. J Bone Joint Surg Br 91(9):1148–1153. https://doi.org/10.1302/0301-620X.91B9.21750

    Article  CAS  PubMed  Google Scholar 

  6. Iwase T, Masui T, Torii Y, Kouyama A (2010) Impaction bone grafting for acetabular reconstruction: mean 5.5-year results in Japanese patients. Arch Orthop Trauma Surg 130(4):433–439. https://doi.org/10.1007/s00402-009-0904-y

    Article  PubMed  Google Scholar 

  7. Garcia-Cimbrelo E, Cruz-Pardos A, Garcia-Rey E, Ortega-Chamarro J (2010) The survival and fate of acetabular reconstruction with impaction grafting for large defects. Clin Orthop Relat Res 468(12):3304–3313. https://doi.org/10.1007/s11999-010-1395-4

    Article  PubMed  PubMed Central  Google Scholar 

  8. Rigby M, Kenny PJ, Sharp R, Whitehouse SL, Gie GA, Timperley JA (2011) Acetabular impaction grafting in total hip replacement. Hip Int 21(4):399–408. https://doi.org/10.5301/HIP.2011.8587

    Article  PubMed  Google Scholar 

  9. van Haaren EH, Heyligers IC, Alexander FG, Wuisman PI (2007) High rate of failure of impaction grafting in large acetabular defects. J Bone Joint Surg Br 89(3):296–300. https://doi.org/10.1302/0301-620X.89B3.18080

    Article  PubMed  Google Scholar 

  10. Garcia-Rey E, Madero R, Garcia-Cimbrelo E (2015) THA revisions using impaction allografting with mesh is durable for medial but not lateral acetabular defects. Clin Orthop Relat Res 473(12):3882–3891. https://doi.org/10.1007/s11999-015-4483-7

    Article  PubMed  PubMed Central  Google Scholar 

  11. D’Antonio JA (1992) Periprosthetic bone loss of the acetabulum. Classification and management. Orthop Clin North Am 23(2):279–290

    PubMed  Google Scholar 

  12. Pai VS (2002) A modified direct lateral approach in total hip arthroplasty. J Orthop Surg 10(1):35–39. https://doi.org/10.1177/230949900201000107

    Article  CAS  Google Scholar 

  13. Nunn D, Freeman MA, Hill PF, Evans SJ (1989) The measurement of migration of the acetabular component of hip prostheses. J Bone Joint Surg Br 71(4):629–631

    Article  CAS  Google Scholar 

  14. Ranawat CS, Dorr LD, Inglis AE (1980) Total hip arthroplasty in protrusio acetabuli of rheumatoid arthritis. J Bone Joint Surg Am 62(7):1059–1065

    Article  CAS  Google Scholar 

  15. Iwase T, Ito T, Morita D (2014) Massive bone defect compromises postoperative cup survivorship of acetabular revision hip arthroplasty with impaction bone grafting. J Arthroplasty 29(12):2424–2429. https://doi.org/10.1016/j.arth.2014.04.001

    Article  PubMed  Google Scholar 

  16. Silverton CD, Rosenberg AG, Sheinkop MB, Kull LR, Galante JO (1996) Revision of the acetabular component without cement after total hip arthroplasty. A follow-up note regarding results at seven to eleven years. J Bone Joint Surg Am 78(9):1366–1370

    Article  CAS  Google Scholar 

  17. Whaley AL, Berry DJ, Harmsen WS (2001) Extra-large uncemented hemispherical acetabular components for revision total hip arthroplasty. J Bone Joint Surg Am 83-A(9):1352–1357

    Article  Google Scholar 

  18. Gross AE, Wong P, Saleh KJ (2000) Grafts and cages: managing massive bone loss. Orthopedics 23(9):973–974

    CAS  PubMed  Google Scholar 

  19. DeBoer DK, Christie MJ, Brinson MF, Morrison JC (2007) Revision total hip arthroplasty for pelvic discontinuity. J Bone Joint Surg Am 89(4):835–840. https://doi.org/10.2106/JBJS.F.00313

    Article  PubMed  Google Scholar 

  20. Gill K, Wilson MJ, Whitehouse SL, Timperley AJ (2013) Results using Trabecular Metal augments in combination with acetabular impaction bone grafting in deficient acetabula. Hip Int 23(6):522–528. https://doi.org/10.5301/hipint.5000053

    Article  PubMed  Google Scholar 

  21. Moličnik A, Hanc M, Rečnik G, Krajnc Z, Rupreht M, Fokter SK (2014) Porous tantalum shells and augments for acetabular cup revisions. Eur J Orthop Surg Traumatol 24(6):911–917. https://doi.org/10.1007/s00590-013-1354-3

    Article  PubMed  Google Scholar 

  22. van Egmond N, De Kam DC, Gardeniers JW, Schreurs BW (2011) Revisions of extensive acetabular defects with impaction grafting and a cement cup. Clin Orthop Relat Res 469(2):562–573. https://doi.org/10.1007/s11999-010-1618-8

    Article  PubMed  Google Scholar 

  23. Onsten I, Carlsson AS, Ohlin A, Nilsson JA (1994) Migration of acetabular components, inserted with and without cement, in one-stage bilateral hip arthroplasty. A controlled, randomized study using roentgenstereophotogrammetric analysis. J Bone Joint Surg Am 76(2):185–194

    Article  CAS  Google Scholar 

  24. Mohaddes M, Herberts P, Malchau H, Johanson PE, Karrholm J (2017) High proximal migration in cemented acetabular revisions operated with bone impaction grafting; 47 revision cups followed with RSA for 17 years. Hip Int 27(3):251–258. https://doi.org/10.5301/hipint.5000452

    Article  PubMed  Google Scholar 

  25. Klerken T, Mohaddes M, Nemes S, Karrholm J (2015) High early migration of the revised acetabular component is a predictor of late cup loosening: 312 cup revisions followed with radiostereometric analysis for 2–20 years. Hip Int 25(5):471–476. https://doi.org/10.5301/hipint.5000246

    Article  PubMed  Google Scholar 

  26. Boldt JG, Dilawari P, Agarwal S, Drabu KJ (2001) Revision total hip arthroplasty using impaction bone grafting with cemented nonpolished stems and charnley cups. J Arthroplasty 16(8):943–952. https://doi.org/10.1054/arth.2001.25559

    Article  CAS  PubMed  Google Scholar 

  27. Buttaro MA, Comba F, Pusso R, Piccaluga F (2008) Acetabular revision with metal mesh, impaction bone grafting, and a cemented cup. Clin Orthop Relat Res 466(10):2482–2490. https://doi.org/10.1007/s11999-008-0442-x

    Article  PubMed  PubMed Central  Google Scholar 

  28. Wilson MJ, Whitehouse SL, Howell JR, Hubble MJ, Timperley AJ, Gie GA (2013) The results of acetabular impaction grafting in 129 primary cemented total hip arthroplasties. J Arthroplasty 28(8):1394–1400. https://doi.org/10.1016/j.arth.2012.09.019

    Article  PubMed  Google Scholar 

  29. Malchau H, Karrholm J, Wang YX, Herberts P (1995) Accuracy of migration analysis in hip arthroplasty. Digitized and conventional radiography, compared to radiostereometry in 51 patients. Acta Orthop Scand 66(5):418–424

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Orthopaedic and Traumatology Department, Assuit University Hospital, Assuit, Egypt

    Mohammad K. Abdelnasser, Ahmed A. Khalifa, Mohammad A. Mahran, Hatem M. Bakr, Yaser E. Khalifa & Ahmed M. Abdelaal

  2. Orthopaedic and Traumatology Department, Qena University Hospital, Qena, Egypt

    Ahmed A. Khalifa

  3. Orthopaedic and Traumatology Department, Al-Azhar University, Assuit Branch, Assuit, Egypt

    Mohamed Mosa

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  1. Mohammad K. Abdelnasser
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Correspondence to Ahmed A. Khalifa.

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Abdelnasser, M.K., Khalifa, A.A., Mahran, M.A. et al. Post-operative hip centre restoration and migration after impaction bone grafting in revision and complex primary hip arthroplasty. Eur J Orthop Surg Traumatol 29, 1411–1417 (2019). https://doi.org/10.1007/s00590-019-02458-8

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