Format

Send to:

Choose Destination
See comment in PubMed Commons below
Clin Orthop Relat Res. 2009 Sep;467(9):2325-34. doi: 10.1007/s11999-009-0777-y. Epub 2009 Mar 18.

Proximal femoral reconstructions with bone impaction grafting and metal mesh.

Author information

  • 1Hip Surgery Unit, Institute of Orthopaedics Carlos E. Ottolenghi, Italian Hospital of Buenos Aires, Potosí 4215 (C1199ACK), Buenos Aires, Argentina. martin.buttaro@hospitalitaliano.org.ar

Abstract

Extensive circumferential proximal cortical bone loss is considered by some a contraindication for impaction bone grafting in the femur. We asked whether reconstruction with a circumferential metal mesh, impacted bone allografts, and a cemented stem would lead to acceptable survival in these patients. We retrospectively reviewed 14 patients (15 hips) with severe proximal femoral bone defects (average, 12 cm long; 14 type IV and one type IIIB using the classification of Della Valle and Paprosky) reconstructed with this method. The minimum followup was 20 months (average, 43.2 months; range, 20-72 months). Preoperative Merle D'Aubigné and Postel score averaged 4.8 points. With revision of the stem as the end point, the survivorship of the implant was 100% at one year and 86.6% at 72 months. The mean functional score at last followup was 14.4 points. We observed two fractures of the metal mesh at 31 and 48 months in cases reconstructed with a stem that did not bypass the mesh. Dislocation (3 cases) and acute deep infection (3 cases) were the most frequent complications. Patients with complete absence of the proximal femur may be candidates for biological proximal femoral reconstructions using this salvage procedure. Bone impaction grafting must be a routine technique if this method is selected.

PMID:
19294476
[PubMed - indexed for MEDLINE]
PMCID:
PMC2866911
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Springer Icon for PubMed Central
    Loading ...
    Write to the Help Desk