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Early complications after one hundred and forty-four consecutive hip revisions with impacted morselized allograft bone and cement

Ornstein, Ewald LU ; Atroshi, Isam LU ; Franzen, Herbert; Johnsson, Ragnar LU ; Sandquist, Per and Sundberg, Martin LU (2002) In Journal of Bone and Joint Surgery. American Volume 84-A(8). p.1323-1328
Abstract
BACKGROUND: The use of impacted morselized allograft bone and cement in hip revision arthroplasty has been popular, but studies that specifically address intraoperative and postoperative complications have been scarce. METHODS: All complications that occurred during, and within the first year after, 144 consecutive hip revision arthroplasties (108 stems and 130 sockets) performed with impacted morselized allograft bone and cement were recorded. Clinical and radiographic follow-up evaluation was performed at three months and at one year after surgery for all patients except eight (seven who had died of causes unrelated to the hip surgery and one who had sustained a stroke). Of these eight patients, seven had a six-week and/or three-month... (More)
BACKGROUND: The use of impacted morselized allograft bone and cement in hip revision arthroplasty has been popular, but studies that specifically address intraoperative and postoperative complications have been scarce. METHODS: All complications that occurred during, and within the first year after, 144 consecutive hip revision arthroplasties (108 stems and 130 sockets) performed with impacted morselized allograft bone and cement were recorded. Clinical and radiographic follow-up evaluation was performed at three months and at one year after surgery for all patients except eight (seven who had died of causes unrelated to the hip surgery and one who had sustained a stroke). Of these eight patients, seven had a six-week and/or three-month follow-up evaluation. RESULTS: Thirty-nine femoral fractures occurred in thirty-seven hips; twenty-nine of the fractures occurred during surgery and ten, within five months after surgery. Of the intraoperative femoral fractures, twelve were proximal, nine were diaphyseal, and eight involved the greater trochanter. Of the postoperative femoral fractures, one was proximal and nine were diaphyseal. Other intraoperative complications were the creation of a femoral cortical window in seven hips and incidental perforation of the femoral cortex in fourteen. Multivariate analysis showed the risk factors for femoral fracture during or after revision to be concomitant disease, greater deficiency of the femoral bone stock, and an intraoperative femoral window or perforation. Other complications included dislocation of the femoral head in nine hips, deep infection in one hip, persistence of preoperative deep infection in one hip, and superficial wound infection requiring wound debridement in two hips. CONCLUSIONS: We found the complication rate to be high after hip revision arthroplasty performed with impacted morselized allograft bone and cement. The most serious complication was postoperative diaphyseal femoral fracture. (Less)
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Contribution to journal
publication status
published
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in
Journal of Bone and Joint Surgery. American Volume
volume
84-A
issue
8
pages
1323 - 1328
publisher
Journal Bone Joint Surgery Inc
external identifiers
  • pmid:12177260
  • scopus:0036704087
ISSN
1535-1386
language
English
LU publication?
yes
id
c12bb07f-ceba-422d-ab6e-54d91e556aac (old id 1125165)
alternative location
http://www.ejbjs.org/cgi/content/abstract/84/8/1323
date added to LUP
2008-05-28 16:00:37
date last changed
2017-12-03 03:23:42
@article{c12bb07f-ceba-422d-ab6e-54d91e556aac,
  abstract     = {BACKGROUND: The use of impacted morselized allograft bone and cement in hip revision arthroplasty has been popular, but studies that specifically address intraoperative and postoperative complications have been scarce. METHODS: All complications that occurred during, and within the first year after, 144 consecutive hip revision arthroplasties (108 stems and 130 sockets) performed with impacted morselized allograft bone and cement were recorded. Clinical and radiographic follow-up evaluation was performed at three months and at one year after surgery for all patients except eight (seven who had died of causes unrelated to the hip surgery and one who had sustained a stroke). Of these eight patients, seven had a six-week and/or three-month follow-up evaluation. RESULTS: Thirty-nine femoral fractures occurred in thirty-seven hips; twenty-nine of the fractures occurred during surgery and ten, within five months after surgery. Of the intraoperative femoral fractures, twelve were proximal, nine were diaphyseal, and eight involved the greater trochanter. Of the postoperative femoral fractures, one was proximal and nine were diaphyseal. Other intraoperative complications were the creation of a femoral cortical window in seven hips and incidental perforation of the femoral cortex in fourteen. Multivariate analysis showed the risk factors for femoral fracture during or after revision to be concomitant disease, greater deficiency of the femoral bone stock, and an intraoperative femoral window or perforation. Other complications included dislocation of the femoral head in nine hips, deep infection in one hip, persistence of preoperative deep infection in one hip, and superficial wound infection requiring wound debridement in two hips. CONCLUSIONS: We found the complication rate to be high after hip revision arthroplasty performed with impacted morselized allograft bone and cement. The most serious complication was postoperative diaphyseal femoral fracture.},
  author       = {Ornstein, Ewald and Atroshi, Isam and Franzen, Herbert and Johnsson, Ragnar and Sandquist, Per and Sundberg, Martin},
  issn         = {1535-1386},
  language     = {eng},
  number       = {8},
  pages        = {1323--1328},
  publisher    = {Journal Bone Joint Surgery Inc},
  series       = {Journal of Bone and Joint Surgery. American Volume},
  title        = {Early complications after one hundred and forty-four consecutive hip revisions with impacted morselized allograft bone and cement},
  volume       = {84-A},
  year         = {2002},
}