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Acetabular Revision with Impacted Morselized Cancellous Bone Graft and a Cemented Cup in Patients with Rheumatoid ArthritisA Concise Follow-up, at Eight to Nineteen Years, of a Previous Report*
B. Willem Schreurs, MD, PhD1; Jaap Luttjeboer, MD1; Truike M. Thien, MD1; Maarten C. de Waal Malefijt, MD, PhD1; Pieter Buma, PhD1; René P.H. Veth, MD, PhD1; Tom J.J.H. Slooff, MD, PhD1
1 Department of Orthopaedics, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. E-mail address for B.W. Schreurs: B.Schreurs@orthop.umcn.nl
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Original Publication Schreurs BW, Thien TM, de Waal Malefijt MC, Buma P, Veth RP, Slooff TJ. Acetabular revision with impacted morselized cancellous bone graft and a cemented cup in patients with rheumatoid arthritis: three to fourteen-year follow-up. J Bone Joint Surg Am. 2003;85:647-52.
Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. A commercial entity (Stryker Howmedica, Montreux, Switzerland) paid or directed in any one year, or agreed to pay or direct, benefits of less than $10,000 to a research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which one or more of the authors, or a member of his or her immediate family, is affiliated or associated.
Investigation performed at the Department of Orthopaedics, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2009 Mar 01;91(3):646-651. doi: 10.2106/JBJS.G.01701
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Abstract: We previously reported our results at a minimum of three years after thirty-five revisions of total hip arthroplasty acetabular components in twenty-eight patients with rheumatoid arthritis. The revisions were performed with use of impacted morselized bone graft and a cemented cup. This update report presents the results at eight to nineteen years after the surgery, which, to our knowledge, is the longest follow-up available in the literature. No patient was lost to follow-up. Since our previous report, there were two additional cup failures due to aseptic loosening, at ten and sixteen years postoperatively. Kaplan-Meier analysis showed the probability of survival of the acetabular component at twelve years to be 80% (95% confidence interval, 65% to 95%) with removal of the cup for any reason as the end point and 85% (95% confidence interval, 71% to 99%) with aseptic loosening as the end point. Cup revisions performed with cement and use of impaction bone-grafting in patients with rheumatoid arthritis led to acceptable long-term prosthetic survival rates. This technique is attractive from a biological standpoint because of the possibility of maintaining acetabular bone stock.

Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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