Structural allografts for bone stock reconstruction in two-stage revision for infected total hip arthroplasty: good outcome in 16 of 18 patients followed for 5-14 years

Acta Orthopaedica
Iulian Nusem, David A F Morgan

Abstract

The use of massive bone allografts in cases of revision of failed total hip arthroplasties (THAs) due to infection is controversial. 18 patients presented with infection at the site of a THA and were treated with a two-stage protocol. In the first stage, the prosthesis was removed together with all necrotic tissues and cement material if present. A custom-made mold of Palacos R cement containing 1 g of gentamicin was then inserted in 17 of the 18 patients. Systemic antibiotics were used during the interval period. In the second stage, the patients had either acetabular or femoral reconstruction using bulk allograft bone. Mean follow-up was 9 (5-14) years. 1 patient presented with recurrent infection and underwent a Girdlestone resection arthroplasty as definitive treatment. Another patient had a mechanical failure of the acetabular component, which was revised 10 years after the second stage of the reconstruction. The mean Harris Hip Score improved from 34 points preoperatively to 71 points at the last review. By our definition, 16/18 of the patients had a successful outcome. Our results support the use of massive allografts in staged reconstructions of infected THAs complicated by considerable bone loss.

References

Feb 1, 1979·Acta Orthopaedica Scandinavica·L Hovelius, G Josefsson
Jan 1, 1981·The Journal of Bone and Joint Surgery. British Volume·H W BuchholzA Siegel
Mar 1, 1994·The Journal of Bone and Joint Surgery. American Volume·B J NestorR H Fitzgerald
Aug 30, 2000·The Journal of Bone and Joint Surgery. British Volume·F S HaddadI Bacarese-Hamilton
Mar 27, 2001·The Journal of Bone and Joint Surgery. American Volume·H R BlackleyA E Gross
Apr 11, 2001·International Orthopaedics·I Ilyas, D A Morgan
Aug 22, 2002·The Journal of Bone and Joint Surgery. British Volume·H EnglishG Gie
Apr 18, 2003·The Journal of the American Academy of Orthopaedic Surgeons·Thomas N JosephPaul E Di Cesare
May 6, 2003·The Journal of Bone and Joint Surgery. British Volume·N J PhillipsD Stanley
Jan 13, 2004·The Journal of Arthroplasty·Rajesh Malhotra, David A f Morgan
Sep 28, 2004·The Journal of Bone and Joint Surgery. British Volume·P Ammon, I Stockley

❮ Previous
Next ❯

Citations

Jul 16, 2013·Clinical Orthopaedics and Related Research·Timothy E EkpoAdolph V Lombardi
Nov 17, 2010·Clinical Orthopaedics and Related Research·Paul T H LeeAllan E Gross
Oct 4, 2006·Clinical Orthopaedics and Related Research·D J ChivasM Tanzer
Nov 15, 2017·The Kaohsiung Journal of Medical Sciences·Yu-Jie SuChung-Hwan Chen
Sep 18, 2012·Clinical Orthopaedics and Related Research·Keith R BerendMichael A Sneller
Dec 17, 2009·Physical Therapy·Miranda C BoonstraNico Verdonschot
Jul 3, 2013·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Marcus P J van DiemenMichiel Mulier
Aug 7, 2014·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Joris B W ElbersBerend W Schreurs
Jul 3, 2013·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Iulian Nusem, David A F Morgan
Jan 5, 2011·The Journal of Bone and Joint Surgery. British Volume·Y-H KimJ-H Joo
Aug 28, 2010·The Journal of Bone and Joint Surgery. British Volume·S I S OussedikF S Haddad
Sep 18, 2015·The Journal of Bone and Joint Surgery. American Volume·Miguel M GomezJavad Parvizi

❮ Previous
Next ❯

Related Concepts

Related Feeds

Aminoglycosides

Aminoglycoside is a medicinal and bacteriologic category of traditional Gram-negative antibacterial medications that inhibit protein synthesis and contain as a portion of the molecule an amino-modified glycoside. Discover the latest research on aminoglycoside here.

Aminoglycosides (ASM)

Aminoglycoside is a medicinal and bacteriologic category of traditional Gram-negative antibacterial medications that inhibit protein synthesis and contain as a portion of the molecule an amino-modified glycoside. Discover the latest research on aminoglycoside here.

Allogenic & Autologous Therapies

Allogenic therapies are generated in large batches from unrelated donor tissues such as bone marrow. In contrast, autologous therapies are manufactures as a single lot from the patient being treated. Here is the latest research on allogenic and autologous therapies.

Antifungals (ASM)

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

Antifungals

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.