Impaction bone grafting in revision hip surgery: past, present and future

McNamara, Iain

doi:10.1007/s10561-009-9147-y

Cited by 33 publications

(20 citation statements)

References 137 publications

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“…Twenty femoral heads were donated by patients who underwent THA and gave previous consent. Cortical and cartilage tissue was removed from the femoral heads with a bone saw, and subsequently bone chips sized 5–10 mm were prepared from the cancellous tissue using a Noviomagus bone mill (Spierings Medische Techniek BV, Nijmegen, The Netherlands) . Bone material was initially fresh‐frozen at −80°C and afterwards stored at −20°C.…”

Section: Methodsmentioning

confidence: 99%

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Optimizing the grain size distribution of allografts in bone impaction grafting

Putzer

Coraça‐Huber

Wurm

et al. 2014

Journal Orthopaedic Research

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In bone impaction grafting, allografts in the form of bone chips are used for reconstruction of defects and to induce bone remodeling. Optimizing grain size distribution of this allograft material should help prevent implant subsidence by achieving higher primary stability of the graft. We evaluated the influence of grain size distribution on the mechanical stability of allograft material. Bone tissue was rinsed, and the grain size distribution of the allograft material was determined by performing a sieve analysis. Uniaxial compression tests were carried out before and after a standardized compaction procedure for samples with controlled grain size distribution and a control group. Allografts with controlled grain size distribution showed a yield limit almost twice as high as in the control group after a standardized compaction procedure. A better interlocking between bone particles was observed compared to the control group. Thus, grain size distribution has a major impact on the mechanical stability of bone grafts. By controlling the grain size distribution of allograft material, a tighter packing can be achieved and subsequently implant subsidence of implants could be avoided. ß

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Section: Methodsmentioning

confidence: 99%

“…Impaction grafting has excellent long term results in primary and revision THA . However, excessive subsidence, peri‐prosthetic fractures, and contamination of the allograft are major complications .…”

mentioning

confidence: 99%

Optimizing the grain size distribution of allografts in bone impaction grafting

Putzer

Coraça‐Huber

Wurm

et al. 2014

Journal Orthopaedic Research

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“…From the remaining cancellous tissue 900 g of bone chips sized 5 mm to 10 mm were prepared using a Noviomagus bone mill (Spierings Medische Techniek BV, Nijmegen, The Netherlands). 12,21,22 All morsellised bone was carefully mixed to achieve homogenous material to minimise any patient-specific bone characteristics. 19,23 The bone chips were not processed any further.…”

Section: Methodsmentioning

confidence: 99%

“…5 Acetabular reconstruction with impacted morsellised cancellous grafts and cement gives satisfactory long-term results. [7][8][9][10][11][12] However, in large acetabular defects micromovement may lead to instability and graft resorption. 13,14 In impaction bone grafting the graft behaves in a viscoelastic fashion and can be considered a friable aggregate.…”

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confidence: 99%

Impaction bone grafting

Putzer

Mayr

Haid

et al. 2011

The Journal of Bone and Joint Surgery. British volume

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In revision total hip replacement, bone loss can be managed by impacting porous bone chips. In order to guarantee sufficient mechanical strength, the bone chips have to be compacted. The aim of this study was to determine in an in vitro simulation whether the use of a pneumatic hammer leads to higher primary stability than manual impaction. Bone mass characteristics were measured by force and distance variation of a penetrating punch, which was lowered into a plastic cup filled with bone chips. From these measurements bulk density, contact stiffness, impaction hardness and penetration resistance were calculated for different durations of impaction. We found that the pneumatic method reached higher values of impaction hardness, contact stiffness and bulk density suggesting an increase in stability of the implant. No significant differences were found between the two different methods concerning the penetration resistance. The pneumatic method might reduce the risk of fracture in vivo, as force peaks are smaller and applied for a shorter period. Results from manual impaction showed higher variability and depend much on the experience of the surgeon. The pneumatic hammer is a suitable tool to standardise the impaction process.

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“…20 On the femoral side nowadays using larger chips is recommended (at least 5 mm proximally and 2 mm to 3 mm distally), as is washing fat and soft tissue off the bone chips. 21,22 More recently, uncemented IBG has gained popularity (Fig.1). 23 An appropriate compaction force is necessary also in the case of cementless cups.…”

Section: Allograftsmentioning

confidence: 99%

Bone grafts, bone graft extenders, substitutes and enhancers for acetabular reconstruction in revision total hip arthroplasty

Pierannunzii

Zagra

2016

EFORT Open Reviews

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Acetabular bone loss is a relevant concern for surgeons dealing with a failed total hip arthroplasty.Since the femoral head is no longer available, allografts represent the first choice for most reconstructive solutions, either as a structural buttress or impacted bone chips.Even though fresh-frozen bone is firmly recommended for structural grafts, freeze-dried and/or irradiated bone may be used alternatively for impaction grafting. Indeed, there are some papers on freeze-dried or irradiated bone impaction grafting, but their number is limited, as is the number of cases.Xenografts do not represent a viable option based on the poor available evidence but bioactive bioceramics such as hydroxyapatite and biphasic calcium phosphates are suitable bone graft extenders or even substitutes for acetabular impaction grafting.Bone-marrow-derived mesenchymal stem cells and demineralised bone matrix seem to act as reliable bone graft enhancers, i.e. adjuvant therapies able to improve the biological performance of standard bone grafts or substitutes. Among these therapies, platelet-rich plasma and bone morphogenetic proteins need to be investigated further before any recommendations can be made.Cite this article: EFORT Open Rev 2016;1:431-439. DOI:10.1302/2058-5241.160025

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Impaction bone grafting in revision hip surgery: past, present and future

Cited by 33 publications

References 137 publications

Optimizing the grain size distribution of allografts in bone impaction grafting

Optimizing the grain size distribution of allografts in bone impaction grafting

Impaction bone grafting

Bone grafts, bone graft extenders, substitutes and enhancers for acetabular reconstruction in revision total hip arthroplasty

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