The Diagnosis and Treatment of Acetabular Bone Loss in Revision Hip Arthroplasty: An International Consensus Symposium.

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Abstract

Conflict of interest statement: Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Peter K. Sculco, MD, reports relationships with EOS Imaging, DePuy Synthes, Intellijoint Surgical, and Parvizi Surgical Innovation. Timothy Wright, PhD, reports relationships with Exactech and LimaCorporate. Mathias Bostrom, MD, reports relationships with Smith & Nephew and Ines Mandl Research Foundation. Farres Haddad, MD, reports relationships with Smith & Nephew, Corin, MatOrtho, Stryker, Bone & Joint Journal, and Annals of the Royal College of Surgeons. Seth Jerabek, MD, reports a relationship with Stryker. Michael Bolognesi, MD, reports relationships with Zimmer Biomet, Exactech, DePuy Synthes, Stryker, American Association of Hip and Knee Surgeons, Total Joint Orthopedics, Eastern Orthopaedic Association, Smith & Nephew, the Pulmonary Embolism Prevention after Hip and Knee Replacement trial funded by Patient-Centered Outcomes Research Institute. Thomas Fehring, MD, reports a relationship with DePuy Synthes. William Jiranek, MD, reports relationships with DePuy Synthes, Moximed, Hip Society, and BioMech Sensor LLC. William Walter, MD, reports relationships with DePuy Synthes, MatOrtho, and NavBit, and has several patents pending or issued. Wayne Papropsky, MD, reports relationships with Zimmer Biomet, Innomed, MicroPort Orthopedics, Intellijoint Surgical, and CeramTec. Thomas Sculco, MD, reports relationships with Exactech and LimaCorporate. Matthew Abdel, MD, reports relationships with Stryker and American Academy of Orthopedic Surgeons. Friedrich Boettner, MD, reports relationships with Smith & Nephew, Ortho Development, and DePuy Synthes. Francesco Benazzo, MD, reports relationships with Zimmer Biomet, LimaCorporate, Fidia, and JACE Medical. Charles Anderson Engh, MD, reports relationships with DePuy Synthes, Smith & Nephew, and Zimmer Biomet. William L. Griffin, MD, reports relationships with DePuy Synthes and Hyalex Corporation. Eric Hansen, MD, reports a relationship with Corin. William Hozack, MD, reports a relationship with Stryker. Stephen Jones, MD, reports relationships with Smith & Nephew, Adler, DePuy Synthes, Zimmer Biomet, Orthofix, and British Hip Society. Gwo-Chin Lee, MD, reports relationships with Stryker, Corin, Heron Therapeutics, Smith & Nephew, DePuy Synthes, KCI USA, Journal of Arthroplasty, Clinical Orthopaedics and Related Research, Journal of Bone & Joint Surgery, Bone & Joint Journal, and the Knee Society. Andrew Manktelow, MD, reports relationships with Zimmer Biomet, MatOrtho, Orthofix, British Hip Society, British Orthopaedic Association, International Hip Society, and European Hip Society. Alex C. McLaren, MD, reports relationships with Arizona Governor’s Grant, National Institutes of Health, Orthopaedic Trauma Association, MusculoSkeletal Infection Society, Sonoran Biosciences, and Hayes Diagnostics. Lawrence O’Hara, MD, reports relationships with Zimmer Biomet. Carsten Perka, MD, reports relationships with DePuy Synthes, Zimmer Biomet, Smith & Nephew, German Society for Orthopaedics and Orthopaedic Surgery, and General Secretary German Arthroplasty Society. Scott Sporer, MD, reports relationships with DJO Surgical, Osteoremedies, Hip Society, Knee Society, and Myoscience. Michael-Alexander Malahias, MD, Alexander Gu, MD, Alejandro Gonzalez Della Valle, MD, Donald Garbuz, MD, Martin Buttaro, MD, Daniel Choi, MD, Eduardo Garcia-Cimbrelo, MD, PhD, Eduardo Garcia-Rey, MD, Thorsten Gehrke, MD, Joe Lipman, MS, and Rob Nelissen, MD, PhD, declare they have no conflicts of interest. 9. Orthop Traumatol Surg Res. 2020 May;106(3):449-458. doi: 10.1016/j.otsr.2020.01.008. Epub 2020 Mar 14. Management and results in periprosthetic tibial fracture after total knee arthroplasty: Two-center 15-case retrospective series at 2 years' follow-up. Bauer C(1), Zaharia B(2), Galliot F(2), Parot J(2), Houfani F(2), Mayer J(3), Mainard D(2). Author information: (1)Service de chirurgie orthopédique et traumatologique, COTA, hôpital Central, CHRU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France. Electronic address: camille.bauer57@gmail.com. (2)Service de chirurgie orthopédique et traumatologique, COTA, hôpital Central, CHRU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France. (3)Service de chirurgie orthopédique et traumatologique, hôpital de Mercy, CHR de Metz-Thionville, 1, allée du Château, 57245 Ars-Laquenexy, France. INTRODUCTION: Periprosthetic tibial fracture after total knee arthroplasty (TKA) is rare, but jeopardizes implant survival. The main objective of the present study was to assess treatment efficacy, on the hypothesis that surgery provides good long-term results. MATERIAL AND METHODS: A two-center retrospective study included 15 patients (6 male, 9 female: mean age, 71.8±10.2 years), managed between 1997 and 2017 for isolated tibial fracture after TKA. Patients were assessed clinically (IKS, inverted Oxford, Parker and SF-12 scores) and radiologically. Complications and revision surgeries were collated. Fractures were classified on the SoFCOT classification: 9 stable implants (4 type B1, 5 type C1), 4 periprosthetic osteolyses (1 type A3, 2 type B3, 1 type C3), and 2 loosenings (type A2). Treatments comprised: non-operative treatment (1 bed-ridden patient), 11 osteosyntheses for fracture on stable implant (2 standard plates, 7 locking plates, 2 intramedullary nailings), and 3 implant replacements by cemented long stem models for loosening. RESULTS: Mean follow-up was 28 months (range, 12-120 months). Consolidation was achieved in 13 cases, at a mean 15 weeks. Complications comprised: 4 infections, 2 cases of secondary displacement, and 2 of non-union. Surgical revision was required in 8 cases, including 2 secondary implant revision procedures. Functional results were good in 10 cases. At last follow-up, mean Parker score was 7 (range, 4-8.5), Oxford score 32 (range, 16-39), and IKS score 150 (range, 85-167) with knee and function scores respectively 78 (range, 55-86) and 75 (range, 30-85). CONCLUSION: Radiologic and clinical results were encouraging, but with impaired quality of life and a high rate of complications. LEVEL OF EVIDENCE: IV, retrospective cohort study. Copyright © 2020 Elsevier Masson SAS. All rights reserved. DOI: 10.1016/j.otsr.2020.01.008