Comparison of re-revision rate and radiological outcomes between Kerboull-type plate and metal mesh with impaction bone grafting for revision total hip arthroplasty

BMC Musculoskeletal Disorders

Research

Daisuke Takahashi¹  Tomohiro Shimizu¹  Mohamad Alaa Terkawi¹  Hotaka Ishizu¹  Norimasa Iwasaki¹  Fumio Sasazawa²  Yusuke Ohashi²  Masahiro Kanayama²  Kaname Takahashi² 

[1] Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-Ku, 060-8638, Sapporo, Japan;Department of Orthopaedic Surgery, Hakodate Central General Hospital, Hon-cho 33-2, 040-8585, Hakodate, Japan;

关键词: Kerboull-type plate;    Revision total hip arthroplasty;    Metal mesh;    Impaction bone grafting;    Vertical defect height;   

DOI  :  10.1186/s12891-023-06240-0

 received in 2022-10-10, accepted in 2023-02-11,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThis study compared the re-revision rate and radiographic outcomes of revision total hip arthroplasty (THA) using a Kerboull-type acetabular reinforcement device (KT plate) with bulk structural allograft and metal mesh with impaction bone grafting (IBG).MethodsNinety-one hips of 81 patients underwent revision THA for American Academy of Orthopedic Surgeons (AAOS) classification type III defects from 2008 to 2018. Of these, seven hips of five patients and 15 hips of 13 patients were excluded due to insufficient follow-up information (< 24 months) and large bone defects with a vertical defect height ≥ 60 mm, respectively. The current study compared the survival and radiographic parameters of 45 hips of 41 patients using a KT plate (KT group) and 24 hips of 24 patients using a metal mesh with IBG (mesh group).ResultsEleven hips (24.4%) in the KT group and 1 hip (4.2%) in the mesh group exhibited radiological failure. Moreover, 8 hips in the KT group (17.0%) required a re-revision THA, while none of the patients in the mesh group required a re-revision. The survival rate with radiographic failure as the endpoint in the mesh group was significantly higher than that in the KT group (100% vs 86.7% at 1-year and 95.8% vs 80.0% at 5-years, respectively; p = 0.032). On multivariable analysis evaluating factors associated with radiographic failure, there were no significant associations with any radiographic measurement. Of the 11 hips with radiographic failure, 1 (11.1%), 3 (12.5%), and 7 (58.3%) hips were of Kawanabe classification stages 2, 3, and 4, respectively.ConclusionsThe findings of this study suggest that revision THA using KT plates with bulk structure allografts could provide poorer clinical outcomes than revision THA using a metal mesh with IBG. Although revision THA using KT plates with bulk structural allografts could set the true hip center, there is no association between a high hip center and clinical outcomes. The relationship between the position of the KT plate and the host bone might be considered more carefully.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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