NDLI: Long-term results for minor column allografts in revision hip arthroplasty.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Lee, Paul T. H. Raz, Guy Safir, Oleg A. Backstein, David J. Gross, Allan E.
Spatial Coverage	Ontario
Description	Country affiliation: Canada Author Affiliation: Lee PT ( Division of Orthopaedic Surgery, Mount Sinai Hospital, 600 University Avenue, Suite 476A, Toronto, ON, M5G 1X5, Canada.)
Abstract	BACKGROUND: While acetabular structural allografts provide an important alternative for reconstructions, concerns remain with long-term graft resorption, collapse, and failure. Midterm studies of minor column (shelf) allograft suggest reasonable survival but long-term survival is unknown. QUESTIONS/PURPOSES: We therefore assessed long-term graft/cup survivorship, functional scores, radiographic resorption, and complications associated with minor column allograft. METHODS: We retrospectively reviewed 74 patients (85 hips) with a mean age of 54 years (range, 28-83 years) undergoing acetabular cup revision using a minor column allograft. A minor column allograft was used in uncontained acetabular bone defects sized between 30% and 50% of the acetabulum. Graft failure was considered to occur when the graft required revision with another graft, metal augment, reconstruction cage, or excision arthroplasty. The minimum followup was 5 years (mean, 16 years; range, 5.3-25 years). RESULTS: Twenty-three patients (27 hips) had rerevision for all causes at a mean time to rerevision of 6.9 years (range, 0.1-23). Fifteen grafts failed at a mean time-to-rerevision of 6.1 years (range, 0.5-23.2). The 15- and 20-year Kaplan-Meier survivorships were 61% and 55% for cups and 78% for grafts with rerevision for all causes as end point. With rerevision for aseptic loosening as end point, survivorships were 67% and 61% for cups and 81% for grafts. The mean modified Harris hip scores were 41 (range, 20-60) preoperatively, 73 (range, 40-95) at 1 year postoperatively and 73 (range, 26-93) at last followup. CONCLUSION: The data may provide a long-term benchmark by which future treatments for Type III defects can be measured.
File Format	HTM / HTML
ISSN	0009921X
e-ISSN	15281132
DOI	10.1007/s11999-010-1591-2
Journal	Clinical Orthopaedics and Related Researchtextregistered
Issue Number	12
Volume Number	468
Language	English
Publisher	Springer
Publisher Date	2010-12-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Orthopaedics Arthroplasty, Replacement, Hip Bone Transplantation Graft Survival Hip Joint Surgery Adverse Effects Instrumentation Hip Prosthesis Kaplan-meier Estimate Ontario Prosthesis Design Prosthesis Failure Radiography Reoperation Retrospective Studies Time Factors Transplantation, Homologous
Content Type	Text
Resource Type	Article
Subject	Orthopedics and Sports Medicine Surgery Sports Science

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