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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2023; 58(03): 523-531
DOI: 10.1055/s-0043-1768619
Artigo Original | Original Study
Quadril

Osseointegration and Success in Hip Arthroplasty Acetabular Revision Using Structured Homologous Graft: Average 9.6 Years Follow-up

Article in several languages: português | English
Bruno Dutra Roos 
1   Serviço de Cirurgia do Quadril, Hospital Ortopédico de Passo Fundo, Passo Fundo, RS, Brasil
,
Milton Valdomiro Roos
2   Serviço de Cirurgia do Quadril, Hospital Ortopédico de Passo Fundo, Passo Fundo, RS, Brasil
,
Antero Camisa Júnior
2   Serviço de Cirurgia do Quadril, Hospital Ortopédico de Passo Fundo, Passo Fundo, RS, Brasil
,
Ezequiel Moreno Ungaretti Lima
2   Serviço de Cirurgia do Quadril, Hospital Ortopédico de Passo Fundo, Passo Fundo, RS, Brasil
,
Maurício Domingos Betto
2   Serviço de Cirurgia do Quadril, Hospital Ortopédico de Passo Fundo, Passo Fundo, RS, Brasil
,
Rafaela Scuzziato Dubiela
3   Departamento de Ortopedia e Traumatologia, Hospital Ortopédico de Passo Fundo, Passo Fundo, RS, Brasil
› Author Affiliations Financial Support The present study did not receive any financial support from either public, commercial or not-for-profit sources.
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Abstract

Objective To evaluate the clinical and radiographic results and survival of the acetabular revision surgery of total hip arthroplasty with cemented implant without the use of reinforcement ring, associated with structural homologous bone grafting.

Methods A total of 40 patients (44 hips) operated from 1995 to 2015 were retrospectively analyzed. Radiographs were evaluated according to the classification of the acetabular bone defect, graft shape, and the presence of osseointegration. Cases were considered as failures when the migration of the implant was > 5 mm in any direction, and/or the progression of radiolucency lines around the acetabular component were > 2 mm. We verified the association of radiographic findings with cases of failure using statistical tests and analyzed survival using the Kaplan-Meier curve.

Results Of the 44 hips, 45.5% of the acetabular defects were Paprosky type 3A and 50% were 3B. In 65% of the hips, the graft configuration was classified as Prieto type 1 and in 31% as type 2. No radiographic evidence of osseointegration was observed in 13.6% of the cases. We observed 9 (20.5%) reconstruction failures. A correlation was observed between reconstruction failure and the absence of radiographic signs of graft osseointegration.

Conclusion We observed good clinic and radiographic results, with survival of 79.54% in a mean follow-up of 9.65 years. Also, there was an association between absence of radiographic signs of osseointegration of the structural graft and failure in this series of patients with large bone defects. The failures did not correlate with the severity of the acetabular bone defect, thickness, or graft configuration.

Keywords

arthroplasty, replacement, hip - grafting, bone - cross-sectional studies - osseointegration - transplantation, homologous, reoperation. - osteointegration

Work developed in the Department of Orthopedics and Traumatology, Hospital Ortopédico de Passo Fundo, Passo Fundo, RS, Brazil.




Publication History

Received: 20 July 2022

Accepted: 04 October 2022

Article published online:
29 June 2023

© 2023. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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