Influence of antibiotic pellets on pore size and shear stress resistance of impacted native and thermodisinfected cancellous bone: An in vitro femoral impaction bone grafting model

Introduction Implant loosening is the most common indication for revision after total hip arthroplasty and is associated with progressive bone destruction. Contained defects can be treated with impaction bone grafting (IBG). Segmental defects are successfully restored with metal augmentation. Considering the increasing number of hip arthroplasty cases in young patients, it would appear sensible to reconstruct the bone stock for future revisions by biological bone defect reduction. The data on the treatment of segmental defects with IBG without additional stabilization are lacking. Materials and methods Paprosky type IIB defects were milled into 15 porcine hemipelves with segmental defect angles of 40°, 80° and 120°. Contained defects without segmental defects (Paprosky type I) and acetabula without defects served as controls. After IBG, a cemented polyethylene cup (PE) was implanted in each case. Cup migration, rotational stiffness and maximum rupture torque were determined under physiological loading conditions after 2500 cycles. Results Compared with the control without defects, IBG cups showed an asymptotic migration of 0.26 mm ± 0.11 mm on average. This seating was not dependent on the size of the defect. The maximum rupture moment was also not dependent on the defect size for cups after IBG. In contrast, the torsional stiffness of cups with an 120° segmental defect angle was significantly lower than in the control group without defects. All other defects did not differ in torsional stiffness from the control without defects. Conclusions IBG did not show inferior biomechanical properties in segmental type IIB defect angles up to 80°, compared to cups without defects.

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“…This was followed by 2 hours of air drying. The bone chips were stored at − 20 °C until use [ 7 , 8 ].…”

Section: Methodsmentioning

confidence: 99%

Impaction bone grafting for segmental acetabular defects: a biomechanical study

Wagener

Martina

Stefan

et al. 2021

Arch Orthop Trauma Surg

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“…One of the potential procedures used in the treatment of chronic osteomyelitis is utilizing a bone graft loaded with antibiotics to be implanted in the defect area. That graft can provide a high and effective concentration of antibiotics at the site of defect with the avoidance of systemic side effects in addition to facilitating bone formation through acting as scaffold (Fölsch et al., 2020 ). Bone grafts can either be autologous if a bone from the donor is transported to another location in the same donor (Miller & Chiodo, 2016 ) or allogenous if a bone from the donor is transported to different receiver (Kumar et al., 2013 ).…”

Section: Systems Under Investigation For the Local Delivery Of Antibiotic For Osteomyelitis Managementmentioning

confidence: 99%