Bony allografts and prosthetic replacement of the acetabular aspect of the hip |
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Authors: | C. Schwartz A. Raye R. Petit |
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Affiliation: | (1) Service d'Orthopédie-Traumatologie, Hôpital Pasteur, F-68024 Colmar Cedex, France;(2) Clinique du Parc, F-69006 Lyon Cedex, France;(3) Clinique St. Sauveur, F-68100 Mulhouse Cedex, France |
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Abstract: | Summary 51 cases of repeat hip replacement have been reviewed, using allografts for acetabular bone loss, stages 2 and 3 (27 lyophilised and 24 deep-frozen). Mean follow-up was 4 years. Loosening was the reason for intervention; 14% of cases were septic. Massive grafts were used in 75% of cases and smaller grafts in 25% of cases. In addition a reinforcement ring was necessary in 75% of cases. Merle d'Aubigné's rating scale was used to assess results. The radiologic assessment score was that of Gross and De Lee.There was no difference between lyophilised and deep-frozen grafts. Clinical scores found 55% of excellent results; 11% were poor, the rest were good or fair. Stability was more troublesome than pain. Radiologic screening showed union between graft and host in 53% of cases but in 41% there was incomplete fusion. In the non-weight-bearing area bone lysis appeared in 14 cases out of 20. Five cases were complete failures; four of these were infected and were reoperated, the bone-graft acting as a foreign body.To date, we have no better bone replacement material than allografts. Fixation of the graft must be secure. An infected hip is not a good indication for this type of operation. Clinical results are satisfactory in more than 80% of cases, although 40% of grafts seem to be incompletely integrated. |
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Keywords: | Graft Bone substitute |
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