Bone graft incorporation after revision hip arthroplasty in patients with rheumatoid arthritis: seventy eight revisions using bone allografts with or without metal reinforcements

Int Orthop. 2013 Apr;37(4):595-8. doi: 10.1007/s00264-013-1794-8. Epub 2013 Feb 8.

Abstract

Purpose: The aim of the study was to assess bone graft incorporation after revision hip arthroplasty in patients with rheumatoid arthritis (RA).

Methods: We report an acetabular reconstruction using impacted, morselized, frozen, radiation sterilized bone allografts in 71 patients suffering from RA. There were sixty-six women and five men at a mean age of 57.5 years. Reconstruction was performed in 78 revision total hip arthroplasties (THAs) for aseptic loosening of acetabular component. The mean follow-up was five years and four months. In 38 cases, a revision was done with use of reinforcement devices.

Results: In four revised hips (10 %) without reinforcement implants, resorption of the allografts was noticed. All Mueller rings and 50 % of unscrews cages (Link, Howmedica) were revised because of aseptic loosening and bone graft resorption. In all of 17 hips with the Burch-Schneider cage, no measurable migration or bone allografts resorption occurred. There were no major general complications.

Conclusions: Acetabular reconstruction with use of morselized, frozen, radiation sterilized bone allografts and the Burch-Schneider cage can be highly successful in managing massive deficiency of acetabular bone stock in revision hip arthroplasty in RA patients.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthritis, Rheumatoid / surgery*
  • Arthroplasty, Replacement, Hip / instrumentation
  • Arthroplasty, Replacement, Hip / methods*
  • Bone Resorption
  • Bone Screws*
  • Bone Transplantation / methods*
  • Female
  • Follow-Up Studies
  • Hip Joint / diagnostic imaging
  • Hip Joint / surgery
  • Hip Prosthesis*
  • Humans
  • Male
  • Middle Aged
  • Prosthesis Failure
  • Radiography
  • Reoperation
  • Transplantation, Homologous
  • Treatment Outcome