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

Abstract

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.

Microvascular response to calcium phosphate bone substitutes: an intravital microscopy analysis

“…Our results found no material-specific reasons for failure of bone substitutes as given in the literature [7,10,30,[35][36][37]. Probably the reasons for failure of substitutes have to be reduced to unspecific reasons like the age of the individual, tissue perfusion (due to sclerosis), and personal habits (smoking), or bony instability.…”

The bone-healing effect of a xenograft in a rat calvarial defect model

“…These results revealed that the tested xenograft did not have an osteoinductive effect, and hence no effect on bone formation. This was rightfully so since Unilab Surgibone ® was defined as an osteoconductive biomaterial 26) , and one should not expect an osteoinductive effect in the defects during bone regeneration. Therefore, as seen in Table 1, there were no significant differences between the two defect sites with regard to bone formation.…”

A New Bone Substitute in the Definitive Management of Furcation Involvement: a Case Report

“…The results are generally positive, with only Charalambides et al (8) reporting poor results. The xenograft was investigated in experimentally created cranial defects in rats, and both short-term and longterm results proved that it is biocompatible, osteoconductive and has no important adverse effects on bone regeneration (5,6).…”