Bone Allografts in Salvage of Difficult Hip Arthroplasties

BORJA, FRANCISCO J.; MNAYMNEH, WAUD

doi:10.1097/00003086-198507000-00015

Cited by 25 publications

(6 citation statements)

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“…Augmentation of autograft in the filling of massive bony defects in reconstructive hip surgery has been tried with allograft (Borja and Mnaymneh 1985, Gross et al 1985, McGann et al 1986, Garbuz et al 1996, Gross 1999. Oonishi et al (1997) described their experience with filling of acetabular defects using hydroxyapatite granules secured with a layer of cement under a cemented acetabular component.…”

Section: Discussionmentioning

confidence: 99%

Poor results after augmenting autograft with xenograft (Surgibone) in hip revision surgery

2005

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Background Surgibone Unilab is prepared from bovine bone and contains hydroxyapatite and protein. It is supposed to be immunogenically inert but the protein could be antigenic in man.Patients and methods We followed 27 patients for an average of 2.5 (1-5) years, all of whom had received Surgibone mixed with autograft to fill in defects in the acetabulum and the proximal femur in revision hip surgery.Results In 17 patients, there was apparently complete incorporation of the bone graft within 6 months. In 3 of these patients, the graft was incorporated after 3 months. In 3 patients, however, there was no incorporation of the graft as late as 3 years after the operation. 3 other patients appeared to have a type of graft rejection (pseudoinfection). 1 other patient suffered MRSA deep infection of the prosthesis which resulted in removal of the implants 1 month postoperatively.Interpretation Use of Surgibone xenograft in revision hip surgery, even in combination with autograft, resulted in failure and the need for rerevision in at least one quarter of the cases studied.

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Section: Discussionmentioning

confidence: 99%

Poor results after augmenting autograft with xenograft (Surgibone) in hip revision surgery

2005

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“…the results of fernoral revisions by simply filling the defects with bone cement are not satisfactory. The uses of different types of structural bone grafts have been described (Borja andMnaynineh 1985, McGann et al 1986, Head et al 1987. Oakcshott et al 1987.…”

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confidence: 99%

Morsellized allografts for fixation of the hip prosthesis femoral component: A mechanical and histological study in the goat

Schreurs

Buma

Huiskes

et al. 1994

Acta Orthopaedica Scandinavica

112

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“…While the use of segmental allografts has solved many problems of reconstruction in musculoskeletal surgery, infection remains a frequent and serious complication, with reported rates of up to 30% in published series of massive allografts. 5,6,[8][9][10][11]16,17,20,21,27,[29][30][31][32][33][34][35][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53] The susceptibility of allografts to infection is multifactorial with avascularity of the allograft, extensive soft-tissue dissection, multiple previous operations, adjuvant chemotherapy and radiotherapy all being contributing factors. [31][32][33] The majority of the infections of bulk allografts occur within the first six months after operation and there is strong evidence that the organisms are introduced at surgery or are related to early wound complications.…”

Section: Discussionmentioning

confidence: 99%

Iontophoresis of antibiotics into segmental allografts

Khoo

Michalak

Yates³

et al. 2006

The Journal of Bone and Joint Surgery. British volume

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Iontophoresis is a novel technique which may be used to facilitate the movement of antibiotics into the substance of bone using an electrical potential applied externally. We have examined the rate of early infection in allografts following application of this technique in clinical practice. A total of 31 patients undergoing revision arthroplasty or surgery for limb salvage received 34 iontophoresed sequential allografts, of which 26 survived for a minimum of two years. The mean serum antibiotic levels after operation were low (gentamicin 0.37 mg/l (0.2 to 0.5); flucloxacillin 1 mg/l (0 to 1) and the levels in the drains were high (gentamicin 40 mg/l (2.5 to 131); flucloxacillin 17 mg/l (1 to 43). There were no early deep infections. Two late infections were presumed to be haemotogenous; 28 of the 34 allografts were retained. In 12 patients with pre-existing proven infection further infection has not occurred at a mean follow-up of 51 months (24 to 82).

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Bone Allografts in Salvage of Difficult Hip Arthroplasties

Cited by 25 publications

References 0 publications

Poor results after augmenting autograft with xenograft (Surgibone) in hip revision surgery

Poor results after augmenting autograft with xenograft (Surgibone) in hip revision surgery

Morsellized allografts for fixation of the hip prosthesis femoral component: A mechanical and histological study in the goat

Iontophoresis of antibiotics into segmental allografts

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