Gamma Irradiation: Effects on Biomechanical Properties of Human Bone-Patellar Tendon-Bone Allografts

Fideler, B. M.; Vangsness, C. Thomas; Lü, Bin; Orlando, Carlo A.; Moore, Tilman

doi:10.1177/036354659502300521

Cited by 233 publications

(205 citation statements)

References 26 publications

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“…3a). These observations are consistent with reports [6,[8][9][10]12,13,19] of the significant effect of gamma irradiation on the plastic properties such as the bending strength and toughness, rather than the elastic properties such as stiffness and elastic limit. Of importance is that although the irradiation doses in question are very large compared to the few second exposures typical of in situ x-ray scattering experiments, they are definitely comparable to the irradiation associated typical tomography imaging runs (Table 1),…”

Section: Strength and Fracture Toughnesssupporting

confidence: 92%

“…At the high dose end (>10 kGy), gamma irradiation is commonly used to terminally sterilize allograft tissues and bones [2][3][4][5], and has been proven to be very potent sterilization agent with the ability to effectively penetrate tissue. However, gamma irradiation is also known to adversely affect the mechanical and biological properties of tissue in a dose-dependent manner by degrading the collagen [6][7][8][9][10][11][12][13][14]. Specifically, gamma rays split polypeptide chains; in wet specimens, irradiation causes release of free radicals via radiolysis of water molecules that induces cross-linking reactions in collagen molecules [15][16][17].…”

Section: Introductionmentioning

confidence: 99%

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On the effect of X-ray irradiation on the deformation and fracture behavior of human cortical bone

Barth

Launey

MacDowell

et al. 2010

Bone

181

109

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In situ mechanical testing coupled with imaging using high-energy synchrotron x-ray diffraction or tomography imaging is gaining in popularity as a technique to investigate micrometer and even sub-micrometer deformation and fracture mechanisms in mineralized tissues, such as bone and teeth. However, the role of the irradiation in affecting the nature and properties of the tissue is not always taken into account. Accordingly, we examine here the effect of x-ray synchrotron-source irradiation on the mechanistic aspects of deformation and fracture in human cortical bone. Specifically, the strength, ductility and fracture resistance (both work-of-fracture and resistancecurve fracture toughness) of human femoral bone in the transverse (breaking) orientation were evaluated following exposures to 0.05, 70, 210 and 630 kGy irradiation. Our results show that the radiation typically used in tomography imaging can have a major and deleterious impact on the strength, post-yield behavior and fracture toughness of cortical bone, with the severity of the effect progressively increasing with higher doses of radiation. Plasticity was essentially suppressed after as little as 70 kGy of radiation; the fracture toughness was decreased by a factor of five after 210 kGy of radiation. Mechanistically, the irradiation was found to alter the salient toughening mechanisms, manifest by the progressive elimination of the bone's capacity for plastic deformation which restricts the intrinsic toughening from the formation "plastic zones" around crack-like defects. Deep-ultraviolet Raman spectroscopy indicated that this behavior could be related to degradation in the collagen integrity.

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Section: Strength and Fracture Toughnesssupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

On the effect of X-ray irradiation on the deformation and fracture behavior of human cortical bone

Barth

Launey

MacDowell

et al. 2010

Bone

181

109

View full text Add to dashboard Cite

show abstract

“…However, many studies (Fideler et al, 1995;Curran et al, 2004) have shown that gamma irradiation has adverse effects on biomechanical properties of allograft in a dose-dependent manner. Fideler et al (1995) demonstrated a dose-dependent effect of irradiation on both the structural and mechanical properties of human BPTB allograft.…”

Section: Discussionmentioning

confidence: 99%

“…Many published studies (Fideler et al, 1995;Curran et al, 2004;Schwartz et al, 2006;Grieb et al, 2006;Balsly et al, 2008) have shown that gamma irradiation significantly alters the initial biomechanical properties of allografts in a dose-dependent manner. A dose as low as 2.5 mrad commonly used by tissue banks has been shown to reduce the initial stiffness and strength of tendon allografts.…”

Section: Introductionmentioning

confidence: 99%

ACL reconstruction with BPTB autograft and irradiated fresh frozen allograft

Kim

Tian

Zhang

et al. 2009

J. Zhejiang Univ. Sci. B

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Abstract:Objective: To analyze the clinical outcomes of arthroscopic anterior cruciate ligament (ACL) reconstruction with irradiated bone-patellar tendon-bone (BPTB) allograft compared with non-irradiated allograft and autograft. Methods: All BPTB allografts were obtained from a single tissue bank and the irradiated allografts were sterilized with 2.5 mrad of irradiation prior to distribution. A total of 68 patients undergoing arthroscopic ACL reconstruction were prospectively randomized consecutively into one of the two groups (autograft and irradiated allograft groups). The same surgical technique was used in all operations done by the same senior surgeon. Before surgery and at the average of 31 months of follow-up (ranging from 24 to 47 months), patients were evaluated by the same observer according to objective and subjective clinical evaluations. Results: Of these patients, 65 (autograft 33, irradiated allograft 32) were available for full evaluation. When the irradiated allograft group was compared to the autograft group at the 31-month follow-up by the Lachman test, the anterior drawer test (ADT), the pivot shift test, and KT-2000 arthrometer test, statistically significant differences were found. Most importantly, 87.8% of patients in the autograft group and just only 31.3% in the irradiated allograft group had a side-to-side difference of less than 3 mm according to KT-2000. The failure rate of the ACL reconstruction with irradiated allograft (34.4%) was higher than that with autograft (6.1%). The anterior and rotational stabilities decreased significantly in the irradiated allograft group. According to the overall International Knee Documentation Committee (IKDC), functional and subjective evaluations, and activity level testing, no statistically significant differences were found between the two groups. Besides, patients in the irradiated allograft group had a shorter operation time and a longer duration of postoperative fever. When the patients had a fever, the laboratory examinations of all patients were almost normal. Blood routine was normal, the values of erythrocyte sedimentation rate (ESR) were 5~16 mm/h and the contents of C reactive protein (CRP) were 3~10 mg/L. Conclusion: We conclude that the short term clinical outcomes of the ACL reconstruction with irradiated BPTB allograft were adversely affected. The less than satisfactory results led the senior authors to discontinue the use of irradiated BPTB allograft in ACL surgery and not to advocate using the gamma irradiation as a secondary sterilizing method.

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“…This risk can be minimized by using various sterilizing methods. However, these methods are complex, expensive and damage the osteogenic properties of the allograft (Ijiri et al 1994, Fideler et al 1995, Thoren and Aspenberg 1995, Currey et al 1997, Aspenberg and Lindqvist 1998, Boyce et al 1999). In our previous study, we found pulse lavage washing very effective in reducing bacterial contamination of the allograft bone (Hirn et al 2001).…”

mentioning

confidence: 99%