TCP-HA Granules and Impacted Morselized Cancellous Bone Graft Mixes for Acetabular Reconstruction with the Bone Impaction Grafting Technique. A Loaded and Critical Sized Defect Model in the Goat

2005 ◽  
Vol 284-286 ◽  
pp. 869-872
Author(s):  
J.J.C. Arts ◽  
J.W.M. Gardeniers ◽  
M.L.M Welten ◽  
N. Verdonschot ◽  
B.W. Schreurs ◽  
...  
Keyword(s):  
Bone Graft ◽  
Cancellous Bone ◽  
Bone Structure ◽  
Giant Cells ◽  
Point Of View ◽  
Acetabular Reconstruction ◽  
Graft Material ◽  
Impaction Grafting ◽  
Grafting Technique ◽  
Bone Impaction Grafting

With the bone impaction grafting technique, a 50/50 volume mix of morselized cancellous bone (MCB) with TCP-HA granules was used to reconstruct a critical sized acetabular defect in the goat. The biological activity of the MCB/TCP-HA mix was assessed after 15 weeks. Defects filled with 100% MCB, currently the gold standard for this technique, were used as controls. In the 100% MCB defects, a new trabecular bone structure was found in which scarce incorporated remnants of the original graft material were present. In the MCB/TCP-HA defects, MCB was also resorbed or incorporated into new bone. Deep in the MCB-TCP-HA defects, large TCP-HA granules were generally totally osseous-integrated with new bone. Superficially, more fragmented TCP-HA granules of various sizes were present in the medullar tissue or in the interface with the cement layer. Here, the crushed TCP-HA granules were generally surrounded by osteoclasts and giant cells. The soft tissue interface between the reconstruction and cement did not differ between both groups. In conclusion, from a biological point of view, this short-term follow-up study suggests that TCP-HA granules can be safely used in a mix with MCB as bone graft extender in acetabular revision surgery with the bone impaction grafting technique.

Cemented Cup Stability during Lever-Out Testing after Acetabular Bone Impaction Grafting with Bone Graft Substitutes Mixes Containing Morselized Cancellous Bone and Tricalcium Phosphate-Hydroxyapatite Granules

2005 ◽  
Vol 219 (4) ◽  
pp. 257-263 ◽  
Author(s):  
J J C Arts ◽  
B W Schreurs ◽  
P Buma ◽  
N Verdonschot
Keyword(s):  
Bone Graft ◽  
Cancellous Bone ◽  
Tricalcium Phosphate ◽  
Calcium Phosphates ◽  
Bone Grafts ◽  
Shear Loading ◽  
Impaction Grafting ◽  
Bone Graft Substitutes ◽  
Bone Impaction Grafting ◽  
Cemented Cup

Bone defects after failed total hip arthroplasty can be reconstructed with impacted morselized bone grafts and a cemented cup. In the near future the amount of bone grafts available for surgical purposes will be insufficient. Ceramic calcium phosphates [tricalcium phosphate (TCP) and hydroxyapatite (HA)] have been widely considered as potential bone graft substitutes or bone graft extenders. In the past, mechanical experiments have been performed to determine implant stability of bone grafts and ceramic TCP-HA granules mixes under a compressive load. However, in-vivo migration studies suggest that shear loading may be equally important. This in-vitro study investigated the initial stability of cups reconstructed with various mixes of bone grafts and ceramic TCP-HA granules in a lever-out situation, where shearing is the predominant loading mode. It was found that the cups reconstructed with mixes of bone graft and TCP-HA granules exhibited greater mechanical stability than the cups reconstructed with bone grafts only. It is concluded that from a mechanical standpoint, when considering shear force resistance, 50–50 per cent volume mix and 25–75 per cent volume mix of morselized cancellous bone graft and TCP-HA granules both provide adequate initial cup stability and can be used for acetabular reconstructions with the bone impaction grafting technique.

Locally administered bisphosphonate in hip stem revisions using the bone impaction grafting technique: a randomised, placebo-controlled study with DXA and five-year RSA follow-up

2018 ◽  
Vol 29 (1) ◽  
pp. 26-34
Author(s):  
Ola Belfrage ◽  
Magnus Tägil ◽  
Martin Sundberg ◽  
Uldis Kesteris ◽  
Gunnar Flivik
Keyword(s):  
Bone Density ◽  
Femoral Stem ◽  
Controlled Study ◽  
First Year ◽  
Allograft Bone ◽  
Impaction Grafting ◽  
Hip Revision ◽  
Grafting Technique ◽  
Bone Impaction Grafting

Background: Bisphosphonates have previously been shown to increase the density of impacted graft bone. In the present study we hypothesise that bisphosphonates also reduce early stem subsidence. We examined the effect of locally applied bisphosphonate to allografts on prosthetic micromotion and bone density in femoral stem revision with impaction grafting. Methods: 37 patients were randomised to either clodronate or saline as local adjunct to the morsellised allograft bone. 24 patients were finally analysed per protocol and evaluated by dual-energy x-ray absorptiometry (DXA) during the first year and with radiostereometric analysis (RSA) for 5 years. Results: There were no significant differences neither in bone density, nor in migratory behaviour between the groups. The femoral stems had subsided 3.6 mm in both groups (p = 0.99) at 5 years and there was no difference as measured over time with mixed models analysis. The clinical outcome was good in both groups. Conclusion: Clodronate as a local addendum to allograft bone in hip revision did not increase bone density or reduce micromotion of the implant.

Acetabular Reconstruction With Bone Impaction Grafting and a Cemented Cup

2001 ◽  
Vol 393 ◽  
pp. 202-215 ◽  
Author(s):  
B. Willem Schreurs ◽  
Tom J. J. H. Slooff ◽  
Jean W. M. Gardeniers ◽  
Pieter Buma
Keyword(s):  
Acetabular Reconstruction ◽  
Impaction Grafting ◽  
Bone Impaction Grafting ◽  
Cemented Cup

scholarly journals Favorable Survival of Acetabular Reconstruction With Bone Impaction Grafting in Dysplastic Hips

2008 ◽  
Vol 466 (2) ◽  
pp. 359-365 ◽  
Author(s):  
Matthijs P. Somford ◽  
Stefan B. T. Bolder ◽  
Jean W. M. Gardeniers ◽  
Tom J. J. H. Slooff ◽  
B. Willem Schreurs
Keyword(s):  
Acetabular Reconstruction ◽  
Impaction Grafting ◽  
Bone Impaction Grafting

scholarly journals Novel Vacuum-Assisted Method for Harvesting Autologous Cancellous Bone Graft and Bone Marrow From the Proximal Tibial Metaphysis

2021 ◽  
Vol 6 (1) ◽  
pp. 247301142098190
Author(s):  
Adam M. Lukasiewicz ◽  
Paul S. Bagi ◽  
Kristin E. Yu ◽  
Vineet Tyagi ◽  
Raymond J. Walls
Keyword(s):  
Bone Marrow ◽  
Bone Graft ◽  
Cancellous Bone ◽  
Proximal Tibia ◽  
Donor Site ◽  
Graft Material ◽  
Cancellous Bone Graft ◽  
Foot And Ankle ◽  
Tibial Metaphysis ◽  
Bone Harvesting

Background: Autogenous cancellous bone graft and bone marrow aspirate are commonly used in lower extremity fusion procedures to enhance fusion potential, and frequently in revision situations where bone loss and osteolysis may be a feature. The tibial metaphysis is a common donor site for bone graft, with the procedure typically performed using a curette or trephine to harvest the cancellous bone. Some limitations of this technique include suboptimal harvest of the marrow portion in particular, incomplete graft harvest, and loss of graft material during the harvest process. We describe a novel vacuum-assisted bone harvesting device to acquire cancellous bone and marrow from the proximal tibia. Methods: This is a retrospective study of a single surgeon’s consecutive patients who underwent foot and ankle arthrodesis procedures using proximal tibia autograft obtained using a vacuum-assisted bone harvesting device. Descriptive statistics were used to summarize patient and operative characteristics and outcomes. We identified 9 patients with a mean age of 51 years, 4 of whom were female. Results: On average, the skin incision was slightly more than 2 cm, and 27 mL of solid graft and 16 mL of liquid phase aspirate were collected. At 6 weeks after the procedure, there was minimal to no pain at the donor site, and we did not observe any fractures or other complications. Conclusions: We report the use of a novel vacuum-assisted curette device to harvest bone graft from the proximal tibial metaphysis for use in foot and ankle fusions. This device has been reliable and efficient in clinical practice. Level of Evidence: Level IV, retrospective case series.

scholarly journals Bone Impaction Grafting with Trabecular Metal Augments in Large Defects in Young Patients: Unravelling A New Perspective in Surgical Technique

2020 ◽  
Author(s):  
Basilio De la Torre-Escurero ◽  
Eva Gómez-González ◽  
Slavador Álvarez-Villar ◽  
Julia Bujan ◽  
Miguel A Ortega
Keyword(s):  
Surgical Technique ◽  
Young Patients ◽  
Case Series ◽  
Abduction Angle ◽  
Acetabular Reconstruction ◽  
Impaction Grafting ◽  
Trabecular Metal ◽  
Bone Impaction Grafting ◽  
Acetabular Defects

Abstract Background: Acetabular reconstruction with bone impaction grafting in large defects has yielded conflicting results. Methods: This was a retrospective study of a case series of five patients with a young age (≤50 years) at the time of surgery who had large acetabular defects reconstructed by bone impaction grafting and trabecular metal augments. The mean follow-up was 79 months. We describe the surgical technique in detail.Results: Improvement was significant on the WOMAC and SF-36 scales (p < 0.05). The radiographs taken at the last follow-up examination showed no migration of the polyethylene cup (p = 0.31) or differences in the abduction angle (p = 0.27) compared to the radiographs from the immediate postoperative period. One patient presented two dislocation episodes as a complication.Conclusion: The combination of trabecular metal augments with the bone impaction grafting technique in young patients with large acetabular defects provides satisfactory results in the long term and restores the bone stock.

Sign in / Sign up

Export Citation Format

Share Document