Incomplete incorporation of morselized and impacted autologous bone graft: A histological study in 4 intracorporally grafted lumbar fractures

Tägil, Magnus; Johnsson, Ragnar; Strömqvist, Björn; Aspenberg, Per

doi:10.3109/17453679908997841

Cited by 23 publications

(20 citation statements)

References 18 publications

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“…Many of these grafts seem to remodel completely on radiographs (Gie et al 1993), but despite these findings, recent histological studies suggest that the allograft may not remodel very much (Tägil et al 1999, Linder 2000. Ingrown fibrous tissue usually supports the graft fragments and forms a mechanically stable composite which, after a brief initial period of remodeling, remains inert (Linder 2000).…”

Section: Discussionmentioning

confidence: 99%

A combination of bisphosphonate and BMP additives in impacted bone allografts

Jeppsson

Åstrand

Tägil

et al. 2003

Acta Orthopaedica Scandinavica

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Section: Discussionmentioning

confidence: 99%

A combination of bisphosphonate and BMP additives in impacted bone allografts

Jeppsson

Åstrand

Tägil

et al. 2003

Acta Orthopaedica Scandinavica

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“…Reported reasons for excessive stem subsidence include cement mantle fracture [30], insufficient graft impaction [38], and the incorporation and remodelling process of the graft layer [12]. Problems with cement mantle fractures have been addressed [17], and extensive research has focused on graft layer properties [1,5,15,37,41] a n d graft incorporation [21,33,34].…”

Section: Introductionmentioning

confidence: 99%

Mechanical characteristics of the bone–graft–cement interface after impaction allografting

Frei

Mitchell

Masri

et al. 2005

Journal Orthopaedic Research

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Impaction allografting is an attractive procedure for the treatment of failed total hip replacements. The graft-cement-host bone interface after impaction allografting has not been characterized, although it is a potential site of subsidence for this type of revision total hip reconstruction. In six human cadaveric femurs, the cancellous bone was removed proximally and local diaphyseal lytic defects were simulated. After the impaction grafting procedure, the specimens were sectioned in 6 mm transverse sections and pushout tests were performed. From the adjacent sections the percentage cement contact of the PMMA cement with the endosteal bone surface was determined. The host bone interface mechanical properties varied significantly along the femur largely due to different interface morphologies. The apparent host bone interface shear strength was highest around the lesser trochanter and lowest around the tip of the stem. A significant positive correlation was found between the percentage cement contact and the apparent host bone interface shear strength (9 = 0.52). The sections failed in 69% of the cases through a pure host bone interface failure without cement or allograft failure, 19% failed with local cement failure, and 12% with a local allograft failure. The apparent host bone interface strength was on average 89% lower than values reported for primary total hip replacements and were similar to cemented revisions proximally and lower distally. This study showed that cement penetration to the endosteal surface enhanced the host bone-graft interface.

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“…2,13 Transpedicular bone grafting has not been proven be advantageous, while it can be potentially dangerous if not placed carefully. 1,14,23,25 In this study, it was hypothesized that reconstruction of the intervertebral disc space by direct restoration of the vertebral endplates, after posterior reduction and stabilization, can restore the anterior column and prevent failure of the posterior construct. The void in the vertebral body that would result from reduction of the endplates could be filled by injecting a bone cement, effectively creating support for the cranial endplate and disc, thereby reducing the risk of recurrent kyphosis after removal of the instrumentation.…”

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confidence: 99%

Balloon Vertebroplasty with Calcium Phosphate Cement Augmentation for Direct Restoration of Traumatic Thoracolumbar Vertebral Fractures

Verlaan

Helden

Oner

et al. 2002

Spine

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Study Design. A human cadaveric model was used to evaluate balloon vertebroplasty in traumatic vertebral fractures.Objectives. To assess the feasibility and safety of balloon vertebroplasty followed by calcium phosphate cement augmentation to prevent recurrent kyphosis.Summary of Background Data. Failure after short-segment pedicle-screw fixation for the treatment of vertebral fractures is probably caused by a redistribution of disc material through the fractured endplate into the vertebral body, causing a decrease in anterior column support. This lack of support can give rise to instrument breakage and recurrent kyphosis after removal of the instrumentation. Restoration of the endplate morphology could prevent these events.Methods. Twenty-three traumatic fractures of thoracolumbar vertebrae were created. All fractures were distracted and fixated with short-segment pedicle screws and rods. Transpedicularly introduced inflatable bone tamps and subsequent injection of calcium phosphate cement were used to restore the endplates. Quantitative analyses of magnetic resonance images obtained at three time points were used to evaluate the morphology of the vertebral body and disc-space. After slicing all specimens, macroscopical examination was performed to detect leakage of cement or bone displacement in undesired directions.Results. No technical problems were encountered during the study. The balloon vertebroplasty resulted in a significant (P ϭ 0.0014) decrease of cranial endplate impression. No cement leakage or undesired bone displacement could be detected radiologically or macroscopically.Conclusions. The present study suggests that balloon vertebroplasty may be a safe and feasible procedure for the restoration of traumatic thoracolumbar vertebral fractures.

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Incomplete incorporation of morselized and impacted autologous bone graft: A histological study in 4 intracorporally grafted lumbar fractures

Cited by 23 publications

References 18 publications

A combination of bisphosphonate and BMP additives in impacted bone allografts

A combination of bisphosphonate and BMP additives in impacted bone allografts

Mechanical characteristics of the bone–graft–cement interface after impaction allografting

Balloon Vertebroplasty with Calcium Phosphate Cement Augmentation for Direct Restoration of Traumatic Thoracolumbar Vertebral Fractures

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