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Total revision of the hip using allograft to correct particle disease induced osteolysis: A case study
DW Taylor, JE Taylor, I Raizman, AE Gross
ABSTRACT: Total hip replacement is considered to be a highly successful and routine surgery;
however, the internal components produce particles through friction and wear in the device. These
particles are identified as one of the main reasons for total hip revisions. The generated, biologically
active, particles provoke the formation of osteolytic areas through the inhibition of bone formation and
increased fluid production. The resulting bone loss can be managed through the use of allograft bone in
combination with bone chips and cement. In addition, implants constructed with highly porous
trabecular metal can be used to further facilitate rapid and extensive tissue infiltration resulting in
strong implant attachment. In this case study we show the use of a tibial allograft coupled with bone
chips and cement to cover and support a lytic cyst in the proximal femur, distal to the greater
trochanter. Additionally, we detail the use of a trabecular metal cup to halt the migration of the
component into the acetabulum and promote greater fixation and bone ingrowth.
KEYWORDS: Revision Hip Arthroplasty, Allograft, Osteolysis, Particle Disease, Trabecular Metal
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