Artificial hips and knees may need to be replaced over time because of loosening and wear. Removing the loosened hip or knee surgically often leaves large bone defects, demanding repair in order to achieve the necessary long term fixation and stability.
Treatment options
Repair of bone defects are managed by the use of special revision implants, and by filling the defects with bone graft normally taken from the patient’s own iliac crest (rim of the pelvis), which requires a second invasive surgical procedure. However, iliac crest grafting can result in donor site pain that often overshadows the pain from the hip/knee operation itself, and the amount of graft available is limited, and so may not be enough to fill the defects created.
Allograft or bone cement may also be used, but allograft carries the risk of transmission of disease because it contains living cells, and bone cement will never remodel into bone. In addition, if a further revision is required, any cement will need to be removed, and this inevitably removes good bone as well.
CERAMENT® provides an attractive alternative treatment option to bone grafting as it can be injected into the bone defect during the procedure, with no need for a second surgical procedure, and will remodel within 6-12 months, allowing for replenishment of bone stock, should a further operation be needed in the future.
References
Malchau H & Herberts P. Prognosis of total hip replacement. The Swedish National Hip Arthroplasty register 1996. Proceedings American Academy of Orthopedic Surgeons. Atlanta: 1996
Namba, RS et al. Risk Factors for Total Knee Arthroplasty Aseptic Revision. J Arthroplasty (2013), http://dx.doi.org/10.1016/j.arth.2013.04.050