Cancellous Allograft in Revision Total Hip Arthroplasty

Leopold, Seth S.; Jacobs, Joshua J.; Rosenberg, Aaron G.

doi:10.1097/00003086-200002000-00010

Cited by 65 publications

(32 citation statements)

References 59 publications

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“…26 Despite the doubts of some authors like Tomford et al, 27 who postulate that only the addition of growth factors would mean that allografts could be osteoinductor, many clinical studies support allograft use and their potential to induce efficient bone repair. 28,29 The present study confirms the active intervention of allografts, even autoclavated, in bone remodeling modulation. One could suppose that frozen and no autoclavated allografts could maintain inside them active growth factors or proteins.…”

Section: Discussionsupporting

confidence: 84%

Osteoinductive effect of bone bank allografts on human osteoblasts in culture

Piedra

Vicario‐Abejón

Acuña

et al. 2007

Journal Orthopaedic Research

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Incorporation of a human bone allograft requires osteoclast activity and growth of recipient osteoblasts. The aim of this work was to study the effects produced by autoclavated and À808C frozen bone allografts on osteoblast proliferation and synthesis of interleukin 6 (IL6), activator of bone resorption, aminoterminal propeptide of procollagen I (PINP), marker of bone matrix formation, and osteoprotegerin (OPG), inhibitor of osteoclast activity and differentiation. Allografts were obtained from human femoral heads. Human osteoblasts were cultured in the presence (problem group) or in the absence (control group) of allografts during 15 days. Allografts produced a decrease in osteoblast proliferation in the first week of the experiment, and an increase in IL6 mRNA, both at 3 h and 2 days, and an increase in the IL6 released to the culture medium the second day of the experiment. We found a decrease in OPG released to the culture on the 2nd and fourth days. These results suggest an increase in bone resorption and a decrease in bone formation in the first week of the experiment. In the second week, allografts produced an increase in osteoblast proliferation and PINP release to the culture medium, indicating an increase in bone formation; an increase in OPG released to the culture medium, which would indicate a decrease in bone resorption; and a decrease in IL6, indicating a decrease in bone resorption stimulation. These results demonstrate that autoclavated and À808C frozen bone allografts produce in bone environmemt changes that regulate their own incorporation to the recipient bone. ß

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Section: Discussionsupporting

confidence: 84%

Osteoinductive effect of bone bank allografts on human osteoblasts in culture

Piedra

Vicario‐Abejón

Acuña

et al. 2007

Journal Orthopaedic Research

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“…Histological examination of retrieved cemented THRs confirmed that radiolucent lines represent areas of cancellization and thinning of the endosteal cortex [24]. Although interpretations of radiographs are difficult, radiolucent lines were observed after impaction allografting and were correlated with stem subsidence [22,26]. These results suggest that the endosteal circulation may be damaged and impaired after a revision with impaction allografting, resulting in medullary widening and potential stem subsidence.…”

Section: Discussionmentioning

confidence: 81%

Biological and mechanical changes of the bone graft–cement interface after impaction allografting

et al. 2005

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In impaction allografting, the host bone interface may consist of morsellized allograft alone or as a composite with bone cement. The objective of this study was to investigate the temporal changes in the interface for these two materials in a rat bone chamber model. To simulate the impaired endosteal circulation after impaction allografting, bone chambers were tightened bilaterally to the endosteal surfaces of proximal tibiae of mature rats and filled with pure allograft or cement/allograft composite. The cement/allograft composite-host bone interface strength was significantly higher at 3 weeks and was higher than the allograft construdt failure strength. Limited allograft, but extensive periosteal remodeling, was observed at 3 weeks which resulted in a significantly increased cortical porosity and cortical thickness. The allograft porosity decreased significantly at 6 weeks indicating extensive remodeling of the allograft bone. Little or no remodeling of the allograft particles in the cement was found. At 6 weeks a new medullary canal was formed, and the endosteal cortex was partially absorbed. Endosteal absorption resulting in medullary canal widening in revision THR may be responsible for clinically unstable stems after impaction allografting.

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“…This vigorous procedure exposes to fracture that remains one of the major complications of the impaction technique (72,(116)(117). Three to five times fewer hammer shocks were needed to impact the freezedried irradiated bone correctly, and less energy was needed to compact the material due to its loss of ductility, reducing the risk of per-operative fracture.…”

Section: Implant Stabilitymentioning

confidence: 99%

Influence of Freeze-Drying and Irradiation on Mechanical Properties of Human Cancellous Bone: Application to Impaction Bone Grafting

Cornu

2012

Bone Grafting

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Cancellous Allograft in Revision Total Hip Arthroplasty

Cited by 65 publications

References 59 publications

Osteoinductive effect of bone bank allografts on human osteoblasts in culture

Osteoinductive effect of bone bank allografts on human osteoblasts in culture

Biological and mechanical changes of the bone graft–cement interface after impaction allografting

Influence of Freeze-Drying and Irradiation on Mechanical Properties of Human Cancellous Bone: Application to Impaction Bone Grafting

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