Ömer Faruk BİLGEN, MÜHAMMET SADIK BİLGEN, Tevfik ÖNCAN, Mutlu DANIŞ

Çimentosuz total kalça protezi revizyonunda impakte kansellöz allogreft ile asetabulum rekonstrüksiyonu

Amaç: Bu çalışmada, revizyon kalça artroplastisinde impakte spongioz allogreft üzerinden yapılan asetabuler komponent tespiti sonrası sağlanan primer ve sekonder stabilitenin değerlendirilmesi amaçlandı. Çalışma planı: İmpakte kansellöz allogreft ve çimentosuz poroz kaplı komponentin %100ünün veya %100e yakınının allogreft ile temas ettiği durumlarda 15 olguda gerçekleştirilen asetabulum rekonstrüksiyonu değerlendirildi. Revizyon sonrası ortalama takip süresi 97.5 (dağılım: 58-130) ay idi. Klinik sonuçların değerlendirilmesinde Harris kalça skorundan yararlanıldı. Radyografik değerlendirmeler son kontrollerde alınan ön-arka grafi görüntülerine dayanarak yapıldı. Bulgular: İki hastaya tekrar revizyon yapıldı. Kalan 13 hastanın son kontroldeki ortalama Harris kalça skoru 88.3±11.9 (dağılım: 68-100) idi. Ameliyat sonrası erken dönem grafilerinde ortalama inklinasyon açısı 45° (dağılım: 30°-55°) olarak ölçüldü. Ortalama migrasyon 6.2±7.8 (dağılım: 0-29) mm idi ve bu mesafe kenar temasına bağlı olarak değişim göstermedi (p=0.054). Migrasyon ve kullanılan greft miktarı arasında korelasyon yoktu (p>0.05). Migrasyon ve takip süresi arasında anlamlı korelasyon vardı (p

Acetabular reconstruction by impacted cancellous allografts in cementless total hip arthroplasty revision

Objective: The aim of this study was to evaluate the primary and secondary stability, where 100% or virtually 100% of the uncemented acetabular component contacted with impacted cancellous allografts, focusing especially on the amount of graft used and rim contact. Methods: Fifteen cases of acetabular reconstruction using impacted cancellous allografts and cementless porous-coated component in which 100% or virtually 100% of the component contacted only with the allograft were reviewed. Mean follow-up was 97.5 (range: 58 to 130) months after revision. The Harris hip score was used to evaluate clinical results. Radiographic evaluations were done using standard anteroposterior views obtained at the final follow-up. Results: Two patients underwent re-revision. The mean Harris hip score of the remaining 13 patients was 88.3±11.9 (range: 68 to 100) at the final follow-up. Early postoperative radiographs showed mean angle of inclination of 45° (range: 30° to 55°). There was a mean migration of 6.2±7.8 (range: 0 to 29) mm and the migration amount did not differ according to rim contact (p=0.054). There was no correlation between migration and amount of graft used (p>0.05). There was a significant correlation between migration and follow-up time (p

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