A Case of Cementless Impaction Bone Graft in a Revision Total Hip Arthroplasty Requiring Calcar Reconstruction

Introduction. In cases of bone deficiency or osteoporosis, and especially in revision cases, there were only two options for treatment until the impaction bone graft procedure was proposed. These were cemented or cementless femoral prosthesis. In the early 1990s, the use of impaction bone graft with...

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Main Authors: Shigeo Ishiguro, Kunihiro Asanuma, Tatsuya Tamaki, Kazuhiro Oinuma, Akihiro Sudo
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Case Reports in Orthopedics
Online Access:http://dx.doi.org/10.1155/2021/8811593
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author Shigeo Ishiguro
Kunihiro Asanuma
Tatsuya Tamaki
Kazuhiro Oinuma
Akihiro Sudo
author_facet Shigeo Ishiguro
Kunihiro Asanuma
Tatsuya Tamaki
Kazuhiro Oinuma
Akihiro Sudo
author_sort Shigeo Ishiguro
collection DOAJ
description Introduction. In cases of bone deficiency or osteoporosis, and especially in revision cases, there were only two options for treatment until the impaction bone graft procedure was proposed. These were cemented or cementless femoral prosthesis. In the early 1990s, the use of impaction bone graft with a cemented mantle had gained popularity and had proven to be clinically effective. In Germany, a cementless impaction bone graft procedure using Corail® (DePuy Synthes) stems was devised, and functional scores were similar to conventional cemented Impaction bone grafts. Case presentation. A 48-year-old man presented with femur loosening of a reamed bipolar arthroplasty performed in 1990. The patient was treated with a cementless impaction bone graft using a Corail® (DePuy Synthes) stem in the femur in revision THA surgery, and the calcar was reconstructed by allograft. Results. At five years, the calcar allograft united with the host bone, and the femoral component showed no subsidence. Conclusion. Calcar reconstruction with a strut allograft, aimed at preventing sinking of the stem was key in this operation. Surgical indication for femoral cementless impaction bone graft should be for loosened femoral prosthesis in a type II Paprosky classification, where only the cortical bone of the isthmus is partially affected, cortical thinning does not exist, and it is mechanically strong enough for the allograft tip impaction. The procedure was safely feasible through the direct anterior approach.
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spelling doaj-art-5a0abc281b64426bb762bda5ca4ba0c62025-08-20T03:34:31ZengWileyCase Reports in Orthopedics2090-67492090-67572021-01-01202110.1155/2021/88115938811593A Case of Cementless Impaction Bone Graft in a Revision Total Hip Arthroplasty Requiring Calcar ReconstructionShigeo Ishiguro0Kunihiro Asanuma1Tatsuya Tamaki2Kazuhiro Oinuma3Akihiro Sudo4Orthopaedic Surgery, Kameyama Medical Center, Mie, JapanDepartment of Orthopaedic Surgery, Mie University Graduate School of Medicine, Mie, JapanFunabashi Orthopaedic Hospital, Chiba, JapanFunabashi Orthopaedic Hospital, Chiba, JapanDepartment of Orthopaedic Surgery, Mie University Graduate School of Medicine, Mie, JapanIntroduction. In cases of bone deficiency or osteoporosis, and especially in revision cases, there were only two options for treatment until the impaction bone graft procedure was proposed. These were cemented or cementless femoral prosthesis. In the early 1990s, the use of impaction bone graft with a cemented mantle had gained popularity and had proven to be clinically effective. In Germany, a cementless impaction bone graft procedure using Corail® (DePuy Synthes) stems was devised, and functional scores were similar to conventional cemented Impaction bone grafts. Case presentation. A 48-year-old man presented with femur loosening of a reamed bipolar arthroplasty performed in 1990. The patient was treated with a cementless impaction bone graft using a Corail® (DePuy Synthes) stem in the femur in revision THA surgery, and the calcar was reconstructed by allograft. Results. At five years, the calcar allograft united with the host bone, and the femoral component showed no subsidence. Conclusion. Calcar reconstruction with a strut allograft, aimed at preventing sinking of the stem was key in this operation. Surgical indication for femoral cementless impaction bone graft should be for loosened femoral prosthesis in a type II Paprosky classification, where only the cortical bone of the isthmus is partially affected, cortical thinning does not exist, and it is mechanically strong enough for the allograft tip impaction. The procedure was safely feasible through the direct anterior approach.http://dx.doi.org/10.1155/2021/8811593
spellingShingle Shigeo Ishiguro
Kunihiro Asanuma
Tatsuya Tamaki
Kazuhiro Oinuma
Akihiro Sudo
A Case of Cementless Impaction Bone Graft in a Revision Total Hip Arthroplasty Requiring Calcar Reconstruction
Case Reports in Orthopedics
title A Case of Cementless Impaction Bone Graft in a Revision Total Hip Arthroplasty Requiring Calcar Reconstruction
title_full A Case of Cementless Impaction Bone Graft in a Revision Total Hip Arthroplasty Requiring Calcar Reconstruction
title_fullStr A Case of Cementless Impaction Bone Graft in a Revision Total Hip Arthroplasty Requiring Calcar Reconstruction
title_full_unstemmed A Case of Cementless Impaction Bone Graft in a Revision Total Hip Arthroplasty Requiring Calcar Reconstruction
title_short A Case of Cementless Impaction Bone Graft in a Revision Total Hip Arthroplasty Requiring Calcar Reconstruction
title_sort case of cementless impaction bone graft in a revision total hip arthroplasty requiring calcar reconstruction
url http://dx.doi.org/10.1155/2021/8811593
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