Descriptive study on the use of irradiated bone allograft in revision hip replacement surgery
DOI:
https://doi.org/10.1016/j.rccot.2017.08.005Keywords:
hip arthroplasty, revision, irradiated bone allograftAbstract
Background: The use of irradiated bone allograft in hip revision is controversial because of the alterations caused by this treatment in the allograft bone. A report is presented on a consecutive series of patients undergoing revision hip replacement using this type of tissue.
Materials and methods: A retrospective evaluation was performed on a series of consecutive cases (2005-2013) of 54 patients (55 hips) operated on by a single surgeon.
Results: Two patients required a new revision and three patients completed without prosthesis due to deep infection. Follow-up of 39 hips was performed, with an improvement in the Merle d’Aubigné-Postel score from 9 to 14. It was found that 11 (40.7%) of the 27 sockets had a migration in some plane greater or equal to 5 mm, and in the remainder all had some migration minus one. The mean subsidence of the femoral stem was 4.9 mm. The incorporation of the graft was in the acetabulum in 14.8% (4/27), and 50% (8/16) in the femur.
Discussion: This series shows excellent clinical results in general, but the irradiated graft in the form of plates for the femur, and structural for the acetabulum has good clinical and radiological results, and good incorporation index. Although the impaction bone grafting had good clinical outcomes and a biological safety, it should be indicated with caution and should never be the first option.
Evidence level: IV
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