TWO-STAGE REVISION HIP REPLACEMENT PATIENS WITH SEVERE ACETABULUM DEFECT (CASE REPORT)
- Authors: Pavlov V.V.1, Kirilova I.A.1, Efimenko M.V.1, Bazlov V.A.1, Mamuladze T.Z.1
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Affiliations:
- Tsivyan Novosibirsk Research Institute of Traumatology and Orthopedics
- Issue: Vol 23, No 4 (2017)
- Pages: 125-133
- Section: Case Reports
- Submitted: 27.12.2017
- Accepted: 27.12.2017
- Published: 27.12.2017
- URL: https://journal.rniito.org/jour/article/view/840
- DOI: https://doi.org/10.21823/2311-2905-2017-23-4-125-133
- ID: 840
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Full Text
Abstract
Favorable short-term results of arthroplasty are observed in 80–90% of cases, however, over the longer follow up period the percentage of positive outcomes is gradually reduced. Need for revision of the prosthesis or it’s components increases in proportion to time elapsed from the surgery. In addition, such revision is accompanied with a need to substitute the bone defect of the acetabulum. As a solution the authors propose to replace pelvic defects in two stages. During the first stage the defect was filled with bone allograft with platelet-rich fibrin (allografting with the use of PRF technology). After the allograft remodeling during the second stage the revision surgery is performed by implanting standard prostheses. The authors present a clinical case of a female patient with aseptic loosening of acetabular component of prosthesis in the right hip joint, with failed hip function of stage 2, right limb shortening of 2 cm. Treatment results confirm the efficiency and rationality of the proposed bone grafting option. The authors conclude bone allograft in combination with the PRF technology proves to be an alternative to the implantation of massive metal implants in the acetabulum while it reduces the risk of implant-associated infection, of metallosis in surrounding tissues and expands further revision options.
About the authors
V. V. Pavlov
Tsivyan Novosibirsk Research Institute of Traumatology and Orthopedics
Email: fake@neicon.ru
Vitaliy V. Pavlov — Dr. Sci. (Med.), Head of the traumatology and orthopedics Department N 2.
17, ul. Frunze, Novosibirsk, 6630091
РоссияI. A. Kirilova
Tsivyan Novosibirsk Research Institute of Traumatology and Orthopedics
Author for correspondence.
Email: IKirilova@niito.ru
Irina A. Kirilova — Dr. Sci. (Med.), Head of the Research Department.
17, ul. Frunze, Novosibirsk, 6630091
РоссияM. V. Efimenko
Tsivyan Novosibirsk Research Institute of Traumatology and Orthopedics
Email: fake@neicon.ru
Maxim V. Efimenko — orthopedic Surgeon, Department of Traumatology and Orthopedics N 2.
17, ul. Frunze, Novosibirsk, 6630091
РоссияV. A. Bazlov
Tsivyan Novosibirsk Research Institute of Traumatology and Orthopedics
Email: fake@neicon.ru
Vyacheslav A. Bazlov — orthopedic Surgeon, Department of Traumatology and Orthopedics N 2.
17, ul. Frunze, Novosibirsk, 6630091
РоссияT. Z. Mamuladze
Tsivyan Novosibirsk Research Institute of Traumatology and Orthopedics
Email: fake@neicon.ru
Tariel Z. Mamuladze — orthopedic Surgeon, Department of Traumatology and Orthopedics N 2.
17, ul. Frunze, Novosibirsk, 6630091
РоссияReferences
- Lachiewicz P.f., Soileau E.S. Tantalum components in difficult acetabular revisions. Clin Orthop Relat Res. 2010. 468(2):454-458. doi: 10.1007/s11999-009-0940-5.
- Paprosky W.G., Perona P.G., Lawrence J.M. Acetabular defect classification and surgical reconstruction in revision arthroplasty. A 6-year follow-up evaluation. J Arthroplasty. 1994;9(1):33-44.
- Тихилов Р.М., Цыбин А.В., Сивков В.С., Гончаров М.Ю., Сементковский А.В., Малыгин Р.В. Сравнительная характеристика различных методик ревизионной артропластики при асептической нестабильности вертлужного компонента эндопротезов тазобедренного сустава. Травматология и ортопедия России. 2007;(1):5-11. Tikhilov R.M., Tsybin A.V., Sivkov V.S., Goncharov M.Yu., Smentkowsky A.V., Malygin V.R. [Comparative characteristics of different methods of revision arthroplasty with aseptic instability of the acetabular component in hip arthroplasty]. Travmatologiya i ortopediya Rossii [Traumatology and orthopedics of Russia]. 2007;(1):5-11. (in Russian).
- Amstutz H.C., Le Duff M.J., Johnson A.J. Socket position determines hip resurfacing 10-year survivorship. Clin Orthop Relat Res. 2012;470(11):3127-3133. doi: 10.1007/s11999-012-2347-y.
- Meehan J., Jamali A.A., Nguyen H. Prophylactic Antibiotics in hip and Knee Arthroplasty. J Bone Joint Surg Am. 2009;91(10):2480-2490. doi: 10.2106/JBJS.H.01219.
- Uchiyama K., Takahira N., Fukushima K., Moriya M., Yamamoto T., Minegishi Y., Sakai R., Itoman M., Takaso M. Two-stage revision total hip arthroplasty for periprosthetic infections using antibiotic-impregnated cement spacers of various types and materials. Scientific World Journal. 2013;2013:147248. doi: 10.1155/2013/147248.
- Ehrenfest D.M., Bielecki T., Mishra A., Borzini P., Inchingolo F., Sammartino G., Rasmusson L., Everts P.A. In search of a consensus terminology in the field of platelet concentrates for surgical use: plateletrich plasma (PRP), platelet-rich fibrin (PRF), fibrin gel polymerization and leukocytes. Curr Pharm Biotechnol. 2012;13(7):1131-1137.
- Kirilova I.A., Sharkeev Yu.P., Podorozhnaya V.T., Popova K.S., Uvarkin P.V. Structural and functional studies of bioobjects prepared from femoral heads In: AIP Conference Proceedings 5. Proceedings of the 5th International Scientific Conference „New Operational Technologies“. 2015;1688(1):030005. doi: 10.1063/1.4936000.
- Кирилова И.А., Шаркеев Ю.П., Подорожная В.Т., Попова К.С., Уваркин П.В., Фомичев Н.Г. Изучение морфологии срединных распилов головки бедренной кости. Успехи современного естествознания. 2015;8:58-61. Kirilova I.A., Sharkeev Yu.P., Podorozhnaya V.T., Popova K.S., Uvarkin P.V., Fomichev N.G. [The study of the morphology of the median cuts the femoral head]. Uspekhi sovremennogo estestvoznaniya [The success of modern science]. 2015;8:58-61. (in Russian).
- Физический статус пациентов по классификации ASA (American Society of Anestesiologists). Режим доступа: http://anest-rean.ru/asa/.
- Morgan G.E., Michail M.S., Murray M.J. Clinical Anesthesiology, 4th ed. Lange Medical Books. McCrawHill, 2006.
- CDC NNIS System. National Nosocomial Infections Surveillance (NNIS) system report, data summary from January 1992 to June 2003, issued August 2003. Am J Infect Control. 2003;31:481-498.
- Jeong M., Kim H.J., Lim S.J., Moon Y.W., Park Y.S. Revision total hip arthroplasty using tantalum augment in patients with paprosky iii or iv acetabular bone defects: a minimum 2-year follow up study. Hip Pelvis. 2016;28(2):98-103. doi: 10.5371/hp.2016.28.2.98.
- George D.A., Gant V., Haddad F.S. The management of periprosthetic infections in the future: A review of new forms of treatment. Bone Joint J. 2015;97-B(9):1162-1169. doi: 10.1302/0301-620x.97b9.35295.
- Анастасиева Е.А., Садовой М.А., Воропаева А.А., Кирилова И.А. Использование аутои аллотрансплантатов для замещения костных дефектов при резекциях опухолей костей (обзор литературы). Травматология и ортопедия России. 2017;23(3): 148-155. doi: 10.21823/2311-2905-2017-23-3-148-155. Anastasieva E.A., Sadovoy M.A., Voropaeva V.V., Kirilova I.A. Reconstruction of bone defects after tumor resection by autoand allografts (review of literature). Travmatologiya i ortopediya Rossii [Traumatology and orthopedics of russia]. 2017;23(3):148-155. (in Russian). doi: 10.21823/2311-2905-2017-23-3-148-155.
- Куляба Т.А., Корнилов Н.Н., Бовкис Г.Ю., Кроитору И.И., Румакин В.П. Костная аллопластика при ревизионном эндопротезировании коленного сустава: гистологическая характеристика структурного трансплантата через 54 месяца после имплантации. Травматология и ортопедия России. 2016;22(4):122-130. doi: 10.21823/2311-2905-2016-22-4-122-130. Kuliaba T.A., Kornilov N.N., Bovkis G.Y., Croitoru I.I., Rumakin V.P. Bone allografting in revision knee arthroplasty: histological characteristics of structural allografts 54 months follow up. Travmatologiya i ortopediya Rossii [Traumatology and orthopedics of russia]. 2016;22(4):122-130. (in Russian). doi: 10.21823/2311-2905-2016-22-4-122-130.
- Movahedian Attar B., Naghdi N., Etemadi Sh.M., Mehdizadeh M. Chin symphysis bone, allograft, and platelet-rich fibrin: is the combination effective in repair of alveolar cleft? J Oral Maxillofac Surg. 2017;75(5): 1026-1035. doi: 10.1016/j.joms.2016.12.026.
- Коротких Д.В., Парфенова А.А. Удар по кризису — A-PRF. Dental Magazine. 2015;141(9):60-63. Korotkih D.V., Parfenova A.A. [A blow to the crisis — A-PRF]. Dental Magazine. 2015;141(9):60-63. (in Russian).
- Duncan W.W., Hubble M.J., Howell J.R., Whitehouse S.L., Timperley A.J., Gie G.A. Revision of the cemented femoral stem using a cement-in-cement technique: a fiveto 15-year review. J Bone Joint Surg Br. 2009;91(5):577-582. doi: 10.1302/0301-620X.91B5.21621.
- Carpenter M.G., Frank J.S., Adkin A.L., Paton A., Allum J.H. Influence of postural anxiety on postural reactions to multi-directional surface rotations. J Neurophysiol. 2004;92(6):3255-3265. doi: 10.1152/jn.01139.2003.
- Haidukewych G.J., Rothwell W.S., Jacofsky D.J., Torchia M.E., Berry D.J. Operative treatment of femoral neck fractures in patients between the ages of fifteen and fifty years. J Bone Joint Surg Am. 2004;86-A(8): 1711-1716.
- Macnicol M.F., Lo H.K., Yong K.F. Pelvic remodeling after the Chiari osteotomy. A long-term review. J Bone Joint Surg Br. 2004;86(5):648-654.
- Чарчян А.Г., Арутюнян Г.Р., Гюлзадян Г.Г., Бахтамян Г.А., Бдоян Г.А., Маргарян А.С. Пластика обширных костных дефектов вертлужной впадины при ревизионных артропластиках. Медицинский вестник Эребуни. 2006;27(3):87-89. Charchyan A.G., Arutyunyan G.R., Gyulzadyan G.G., Bakhtamyan G.A., Bdoyan G.A., Margaryan A.S. [Plasty of extensive bone defects of the acetabulum in revision arthroplasty]. Meditsinskii vestnik Erebuni [Medical Journal Ereboun]. 2006;27(3):87-89. (in Russian).