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Bone graft substitutes in hip revision surgery: a comprehensive overview
Andrew Beswick1, Ashley W Blom
1Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Avon Orthopaedic Centre, Southmead Hospital, Bristol BS10 5NB, United Kingdom. andy.beswick@bristol.ac.uk
Injury
|July 15, 2011
Summary
Bone graft substitutes show promise for hip revision surgery, offering an alternative to limited autografts and allografts. Further randomized controlled trials are needed to confirm their effectiveness and patient experience.
Area of Science:
- Orthopedic surgery
- Biomaterials science
Background:
- Total hip replacement (THR) is common, but revision surgery is increasing, especially for younger patients.
- Bone stock loss is a major challenge in revision surgery, with limited supplies of autografts and allografts.
- Bone graft substitutes (BGS) present a potential alternative for reconstructing bone stock in hip revision procedures.
Purpose of the Study:
- To systematically review empirical studies on the use of bone graft substitutes in hip revision surgery.
Main Methods:
- Systematic review using Cochrane and MOOSE methodologies.
- Searched MEDLINE and EMBASE databases up to December 2010.
- Included all human studies regardless of design, examining hip replacement and bone graft substitute literature.
Main Results:
- Identified 397 articles, with 7 studies on BGS combined with grafts and 6 on exclusive BGS use.
- No randomized controlled trials (RCTs) were found; studies had small patient numbers and short follow-up.
- Ceramic bone graft substitutes, excluding glass ceramic, demonstrate potential as alternatives to autografts/allografts.
- Calcium phosphate ceramic BGS may offer cost savings.
Conclusions:
- Bone graft substitutes are essential for hip revision due to allograft shortages.
- High-quality RCTs are needed to compare BGS efficacy against established practices.
- Future research should assess patient-reported outcomes alongside prosthesis-related results.