Journal
JOURNAL OF ARTHROPLASTY
Volume 36, Issue 4, Pages 1413-1419Publisher
CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS
DOI: 10.1016/j.arth.2020.10.023
Keywords
cortical strut allograft; femoral bone defect; resorption; survival; total hip revision
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This retrospective study investigated the resorption of grafts used in revision total hip arthroplasties and found that the resorption rate increases proportionally with the follow-up duration and can be very severe in a high percentage of cases. Long-term multicenter studies are needed to assess the impact of resorption on prosthesis longevity.
Background: Despite the widespread use of revision total hip arthroplasties using cementless stems and cortical strut allografts, graft resorption has not been explicitly studied. Methods: Between 2010 and 2018, 40 femoral strut grafts were used in the revision of femoral stems of 36 patients (18 males and 18 females; average age, 51.9 +/- 12.9 years). The mean follow-up was 78.9 +/- 37.3 months. Failure was defined as revision surgery for any reason and subsidence of greater than 5 mm. Results: The survival rate of the stem without the need for revision at 5 years was 95% (mean graft survival time, 10.8 [95% CI, 9.414-12.234] years). Overall survival with graft resorption as the endpoint was 90% at 5 years (mean graft survival time, 8.8 [95% CI, 7.5-10.2] years). Survival with graft nonunion as the endpoint was 90% at 3 years (mean survival time, 11.7 [95% CI, 10.5-12.8] years). Conclusion: The resorption rate increases proportionally to the follow-up duration and can be very severe in a high percentage of cases. Long-term multicenter studies are required to assess the effect of resorption on prosthesis longevity. (C) 2020 Elsevier Inc. All rights reserved.
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