Impaction technique and graft treatment in revisions of the femoral component

Höstner, J.; Hultmark, Peter; Kärrholm, Johan; Malchau, Henrik; Tveit, Magnus

doi:10.1054/arth.2001.9830

Cited by 64 publications

(40 citation statements)

References 15 publications

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“…The first step of freeze-dried bone process is the removal of bone marrow and cell remains by solvent-detergent (Delloye et al 1987). Many authors have reported an improvement in implant stability in femoral and acetabular impactions using a morselized graft that had been simply washed with saline (Kärrholm et al 1999, Ullmark 2000, Höstner et al 2001. In clinical studies, good results have also been reported using defatted freeze-dried bone (Mazhar et al 2001, de Roeck and Drabu 2001, Thien et al 2001.…”

Section: Discussionmentioning

confidence: 99%

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Freeze-dried irradiated bone brittleness improves compactness in an impaction bone grafting model

Libouton

Naets

Godts

et al. 2004

Acta Orthopaedica Scandinavica

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Background Defatted bone chips with or without freeze-drying and irradiation have mechanical advantages as compared to fresh-frozen controls in in vitro models of impaction. These improved results have been ascribed to replacement of viscous bone marrow by saline and embrittlement of the freeze-dried bone by irradiation.Material and methods To determine which of these hypotheses is correct, we compared the development of stiffness and compactness of morselized bone graft that had been: 1) fat-reduced with saline, and 2) fresh-frozen, solvent-detergent defatted, 3) freeze-dried irradiated and 4) not irradiated. We used 12 osteoarthrotic femoral heads to prepare these four batches of morselized bone, and impacted 18 samples from each batch in a cylinder. The frozen bone grafts were tested after thawing at room temperature for 2 hours and the freeze-dried grafts were tested after 30 minutes of rehydration. We monitored the development of compactness and stiffness of the material during impaction.Results The stiffness of the freeze-dried irradiated bone was greater than that of the other three series after 10, 50 and 150 impactions. The freeze-dried bone chips that were not irradiated and the chips defatted with saline alone were less stiff than the fresh-frozen control after 150 impactions.Interpretation The brittleness of freeze-dried irradiated bone, caused by loss of the capacity to absorb energy in a plastic way, increases the compactness and stiffness of the morselized grafts. Washing bone with saline alone or treating bone with solvent-detergent but no irradiation had no similar mechanical advantage and the bone did not impact better than fresh-frozen undefatted bone in our model.

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Section: Discussionmentioning

confidence: 99%

“…Two hypotheses were advanced to support this observation. First, the replacement of viscous bone marrow by saline in the freeze-dried bone might accelerate the compaction of the grafts (Höstner et al 2001). Secondly, the embrittlement due to bone processing (Cornu et al 2000) could be of value in impaction bone grafting.…”

mentioning

confidence: 99%

Freeze-dried irradiated bone brittleness improves compactness in an impaction bone grafting model

Libouton

Naets

Godts

et al. 2004

Acta Orthopaedica Scandinavica

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“…Our impaction technique corresponded to the one described by Gie et al (1993), except for the use of polished rotating reamers during the initial phase of impaction in 24 cases (11 S, 13 C) (Höstner et al 2001). In 2 cases (control group), whether this technique or the conventional technique was used had not been recorded.…”

Section: Methodsmentioning

confidence: 99%

Mixing bone graft with OP-1 does not improve cup or stem fixation in revision surgery of the hip: 5-year follow-up of 10 acetabular and 11 femoral study cases and 40 control cases

et al. 2006

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“…The treatment has been described using extensively coated femoral stems [3,13,26], modular stems with distal tapers [10,12,14,15,17,19,22], and impaction bone grafting with cemented polished stems [4,7,16,21,23,25,27]. Femoral impaction grafting, first reported by Gie et al in 1993 [5], has the advantage of adding bone to the deficient femur, but it is a time-consuming procedure with reported risks of fracture ranging from 5% to 12% [1,5,7,9].…”

Section: Introductionmentioning

confidence: 99%

What is the Long-term Survival of Impaction Allografting of the Femur?

Garvin¹,

Konigsberg²,

Ommen³

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Revision hip surgery of the femur for patients with substantial bone loss is challenging. We previously reported 41 patients (44 hips) treated with femoral impaction grafting followed for a minimum of 2 years. The survivorship, using femoral reoperation for symptomatic aseptic loosening as the end point, was 97% at 8 years. However, data on longer term survival are crucial to adequately compare this surgical technique with other types of revision hip arthroplasty procedures. Questions/purposes We therefore asked what the survivorship of impaction bone grafting was at longer followup, if the severity of bone loss was associated with failure, and finally, if longer length stems had improved survival compared with shorter stems.Methods Between 1993 and 2002, 78 femoral revisions were performed in 71 patients using impaction grafting. The average age of the patients was 67 years (range, 33-84 years). Sixty-nine of the 71 patients were available for followup evaluation. We obtained Harris hip scores preoperatively and postoperatively. Radiographs were measured for radiolucent lines. Patients were followed a minimum of 2 years (average, 10.6 years; range, 2-19 years).

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Impaction technique and graft treatment in revisions of the femoral component

Cited by 64 publications

References 15 publications

Freeze-dried irradiated bone brittleness improves compactness in an impaction bone grafting model

Freeze-dried irradiated bone brittleness improves compactness in an impaction bone grafting model

Mixing bone graft with OP-1 does not improve cup or stem fixation in revision surgery of the hip: 5-year follow-up of 10 acetabular and 11 femoral study cases and 40 control cases

What is the Long-term Survival of Impaction Allografting of the Femur?

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