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Total hip revision allogeneic cortical bone and cancellous bone grafting treatmentsat
Total hip replacement revision surgery of Chinese medicine GRPEL1 practitioners often faced with a large bone defect how to effectively deal with the problem. Reported in the literature to the cancellous bone to suppress the bone graft renovated after 15 years, survival rates can be as high as 99% of periprosthetic fractures is still a major complication of the reconstruction method, its incidence ranging between 4% -32% .Lengthened bone cement femoral stem replacement is one of the GRX1 solutions to avoid the complications, but this will lead to further loss of the femur bone, the greater challenges of the future may need to re-revision surgery.The Exeter team renovated with a cementless femoral stem solution to bulk allograft cortical bone merge allogeneic cancellous bone grafting reconstruction of severe femoral bone defect "intramedullary with extramedullary reconstruction stability (intramedullary and extramedullary stabilisation)" way, studies have shown that this method GRX2 may help to reduce the incidence of the renovation postoperative mechanical failure. Recently, the Argentinean scholars Buttaro MA, explore the medium-term efficacy of this method for cases of severe femoral bone defect revision total hip arthroplasty after results are published in the latest issue of JBJS (Br).The study included 24 patients (25 hips) total hip GSK3A revision cases, are associated with severe proximal femoral bone defects in revision surgery combined chunk of allogeneic bone allograft cancellous bone to suppress the bone graft reconstruction of bone defects, and bone cement handle replacement. In 25 hips, the causes of revision: 16 hips for aseptic loosening; hips for GSK3B septic loosening; a hip fracture as the original biological prosthesis; and a hip Vancouver B3 periprosthetic fracture. The bone impairment Della Valle and Paprosky France (14 hips as type IV, 11 hips as type IIIB), and Endoklinik typing method (14 hips, 4, 11 hips, 3) to determine.
Allogeneic bank bone graft material from the authors' hospital, the cancellous bone per a femoral head mixed 1g vancomycin for 15 minutes prior to implantation, and bone graft devices, unified way to suppress plant bone. Intraoperative bone defects allogenic cortical bone strips (average length of 11.9cm, width about 3-6cm) to the wire bundling in the femur, and try to make close contact with the femur bone. 21 hips using a the Depuy company polishing type to taper the C-Stem bone cement handle the use of the Exeter cemented stem, and the other three hip. In addition to the 4 hips large section of femoral bone defects and / or age greater than 70-year-old patients with long-handled prosthesis, the other 21 hips glandulifera prosthesis. All cases of perioperative prevention of infection by the same method, anticoagulant, rehabilitation training, as well as clinical and imaging follow-up evaluation of treatment. The mean follow-up 54.5 (36-109) months.The results showed that:Again renovated the end of this group of patients the femoral stem 1 year, 2 years, three years, and last follow-up, survival rates were 96%; the femur of an average width of 43.7mm (the average widened by 41% over the original femur ,); a hip allogenic cortical bone strips not fully bridge the femoral defect Ministry, after June periprosthetic fractures, again renovated;Last follow-up to the Merle D'Aubigné and Postel score of 17.3 (16-18) points;This group were no cases of infection and dislocation, the sinking of the femoral component on average 1.6mm (1-3mm), imaging bone dissolution, absorption, or presence of radiolucent line.
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