Outcome of revision total knee arthroplasty with bone allograft in 30 cases.

Revision Total Knee Arthroplasty is often complicated by large bone defects in the distal femur and proximal tibia. These defects can be managed in a variety of ways including the use of allograft bone. The purpose of this study was to retrospectively evaluate the clinical outcome of revision total knee arthroplasty cases where allograft bone was used.

Reducing the radiation sterilization dose improves mechanical and biological quality while retaining sterility assurance levels of bone allografts.

Background: Bone allografts carry a risk of infection, so terminal sterilization by gamma irradiation at 25kGy is recommended; but is deleterious to bone quality. Contemporary bone banking significantly reduces initial allograft bioburden, questioning the need to sterilize at 25kGy.

Methods: We inoculated allograft bone with Staphylococcus epidermidis and Bacillus pumilus, then exposed them to gamma irradiation at 0, 5, 10, 15, 20 and 25kGy.

The use of Gamma-irradiated proximal femoral allografts for bone stock reconstruction in complex revision hip arthroplasty.

We have followed a consecutive series of 49 revision hip arthroplasties, performed for severe femoral bone loss using Gamma-irradiated anatomic-specific proximal femoral allografts longer than five centimetres. The patients were followed for a median 10.2 years, with a five year minimum follow-up.

11 kGy gamma irradiated demineralized bone matrix enhances osteoclast activity.

Background: Demineralized bone matrix (DBM) allografts are widely used in orthopaedic clinics. However, the biological impact on its osteoinductivity after its sterilization process by gamma irradiation is not well studied. Furthermore, little is known about the relationship between residual calcium levels on osteoinductivity.

Sponge swabs increase sensitivity of sterility testing of processed bone and tendon allografts.

Sterility testing is the final, and critical, step in quality control of tissue banking. It informs the decision whether to release the tissue allografts for clinical use, or not. The most common method for sterility testing of structural bone and tendon allografts is to swab using cotton tip streaks.

Validation of 11 kGy as a radiation sterilization dose for frozen bone allografts.

A radiation sterilization dose (RSD) of 25 kGy is deleterious to bone allografts. This study aimed to establish a lower RSD for bone allografts using method 1 of International Standard Organisation 11137.2:2006.

Computer-assisted vs conventional mechanical jig technique in hip resurfacing arthroplasty.

To compare the effectiveness of computer-assisted surgery (CAS) and mechanical jig technique in hip resurfacing arthroplasty, we reviewed 176 hip resurfacing arthroplasty performed in 158 patients. The initial 131 hips were resurfaced using the conventional mechanical jig technique, and the remaining 45 hips with the CAS technique. The demographic data of the patients were similar for both techniques.

Validation of 15 kGy as a radiation sterilisation dose for bone allografts manufactured at the Queensland Bone Bank: application of the VDmax 15 method.

Background: ISO 11137-2006 (ISO 11137-2a 2006) provides a VDmax 15 method for substantiation of 15 kGy as radiation sterilisation dose (RSD) for health care products with a relatively low sample requirement. Moreover, the method is also valid for products in which the bioburden level is less than or equal to 1.5.

Sterilization of allograft bone: effects of gamma irradiation on allograft biology and biomechanics.

Gamma irradiation from Cobalt 60 sources has been used to terminally sterilize bone allografts for many years. Gamma radiation adversely affects the mechanical and biological properties of bone allografts by degrading the collagen in bone matrix. Specifically, gamma rays split polypeptide chains.

Sterilization of allograft bone: is 25 kGy the gold standard for gamma irradiation?

For several decades, a dose of 25 kGy of gamma irradiation has been recommended for terminal sterilization of medical products, including bone allografts. Practically, the application of a given gamma dose varies from tissue bank to tissue bank. While many banks use 25 kGy, some have adopted a higher dose, while some choose lower doses, and others do not use irradiation for terminal sterilization.

Structural allografts for bone stock reconstruction in two-stage revision for infected total hip arthroplasty: good outcome in 16 of 18 patients followed for 5-14 years.

Background: The use of massive bone allografts in cases of revision of failed total hip arthroplasties (THAs) due to infection is controversial.

Patients And Methods: 18 patients presented with infection at the site of a THA and were treated with a two-stage protocol. In the first stage, the prosthesis was removed together with all necrotic tissues and cement material if present.

Mechanical properties of gamma irradiated morselized bone during compaction.

This study examined the effects of gamma irradiation on the compressive properties of morselized cancellous bone from human femoral heads. Twelve bone samples, mean age of 68 years (range 92-39), were divided into 3 groups (N=12) of varying irradiation level (0, 15 and 25 kGy). Each specimen was compacted in a controlled fashion in steps of 0.

Role of core biopsy in diagnosing infection before revision hip arthroplasty.

A prerevision core biopsy from a failed hip joint was performed in 41 hips (38 patients) with a high index of suspicion for sepsis to determine its efficacy in diagnosing sepsis. Seven hips were known septic failures, and core biopsy was undertaken to confirm resolution of sepsis. Forty hips were revised, whereas 1 hip had excision of heterotopic bone.