Introduction: Impacted morselized bone allograft is thought to be remodeled to a great extent. We have previously shown that load-bearing increases the remodeling of impacted morselized bone allografts in a rabbit knee prosthesis model. Bone Morphogenic Proteins (BMPs) also stimulate bone formation and bone allograft remodeling. In this study, our aim was to determine whether it was possible to increase further the remodeling of impacted morselized bone allografts by combining load-bearing with a BMP.
Experiment: A solution of Osteogenic Protein-1 (OP-1, also called BMP-7) was added to freeze-dried bone allograft chips before impaction grafting in our rabbit knee prosthesis model. 23 skeletally mature rabbits received an uncemented tibial knee prosthetic component inserted into a bed of impacted morselized bone allograft. 12 rabbits were given OP-1-treated allograft (50 microg OP-1 per gram allograft), and 11 rabbits vehicle-treated allograft. Each rabbit received mean 0.53 g graft. The rabbits were killed after 3 or 6 weeks and the grafted region was examined by histomorphometric assessment of the volume fraction of newly formed bone and remaining graft.
Results And Interpretation: We found that OP-1 did not increase the bone density (graft plus new bone) to any substantial extent. However, we can not exclude that this might be due to a carrier problem, since the OP-1 was added as a solution directly to the dry graft.
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http://dx.doi.org/10.1080/00016470310018306 | DOI Listing |
Arthroplast Today
August 2023
Department of Mechanical Engineering, Indian Institute of Technology, Delhi, New Delhi, India.
Background: Impaction of morselized allograft is an appealing procedure for addressing the bone defects. However, concerns remain about its suitability for massive defects. We used a novel "sandwich" technique by impacting the morselized allograft in layers with an intervening layer of injectable bone graft substitute for restoring bone defects during acetabular reconstruction in total hip arthroplasties.
View Article and Find Full Text PDFArch Orthop Trauma Surg
October 2023
Division of Orthopaedics, Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
Introduction: Several studies have reported good to excellent outcomes of revision total hip arthroplasty (rTHA) using allografts for treating severe acetabular bone defects. However, precise information on the impact of allograft type and reconstruction method is not available.
Material And Methods: Systematic literature search was performed in Medline and Web of Science including patients with acetabular bone loss classified according to the Paprosky classification who underwent rTHA involving the use of allografts.
Orthop Rev (Pavia)
October 2022
Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia (Italy); IRCCS Hospital San Matteo, Pavia (Italy).
Femoral shaft nonunions are disabling complications of fractures, with relevant socioeconomic and psychological impact. The incidence of femoral shaft nonunions is not negligible, ranging between 1% and 10% after intramedullary nailing, but can exceed 20% in case of subtrochanteric fractures. Treatment options are influenced by pathomechanical, anatomical, and clinical factors.
View Article and Find Full Text PDFMaterials (Basel)
May 2022
Hip Department, IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy.
Total hip arthroplasty (THA) is increasingly performed in young patients and the number of revisions is estimated to rise over time. Acetabular osteolysis and bone loss are frequently encountered during revision and may be classified and treated in different ways. Impaction bone grafting (IBG) with morselized allograft offers a viable option.
View Article and Find Full Text PDFJ Bone Joint Surg Am
November 2021
Department of Trauma and Orthopaedic Surgery, Division of Orthopaedics, University Medical Center Hamburg-Eppendorf,Hamburg, Germany.
Background: Impacted bone-grafting with morselized allograft chips is commonly used to reconstruct acetabular bone defects in revision total hip arthroplasty (THA). While the overall clinical outcome of this procedure is described to be excellent, the microstructural basis and histological determinants of allograft incorporation remained to be further elucidated.
Methods: The acetabula of 23 individuals with documented previous use of allograft chips during revision THA were explanted post mortem.
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