Abstract
Introduction
Impacted cancellous allograft for the femur reported by Gie et al. (1993) has resulted in a good outcome. Revascularization of the graft was proven with plain radiographs or in some cases, biopsy and autopsy. We have attempted to document the change in appearance of impacted cancellous allograft in the femur over time on scintigraphic scans.
Materials and methods
Bone scintigraphy was conducted following total hip arthroplasty of 20 hips without complication using impacted cancellous allograft. At 6 weeks, 1, 2 and 4 years postoperatively, uptake at 5 regions of interest around the femoral component sites was measured.
Results
At all 5 regions of interest, uptake was significantly decreased at 1 year postoperatively compared with that at 6 weeks postoperatively. At 2 and 4 years postoperatively, uptake was about 2-fold that of the normal femur in the greater trochanter, lesser trochanter, and stem tip and had decreased to almost the normal level at the lateral stem and medial stem.
Conclusion
In revision hip arthroplasty using impacted cancellous allograft, remodeling of the grafted bone of the femur was still incomplete, particularly at the greater trochanter, lesser trochanter, and stem tip even after 4 years postoperatively. It is felt that further time is required for remodeling.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Caniggia M, Burroni L (1991) Bone scanning in the evaluation of total hip replacement. Ital J Orthop Traumatol 17:375–379
Elting JJ, Mikhail WEM, Zicat BA, Hubbell JC, Lane LE, House B (1995) Preliminary report of impaction grafting for exchange femoral arthroplasty. Clin Orthop 319:159–167
Engelbrecht E, Heinert K (1987) Klassifikation und Behandlungsrichtlinien von Knochensubstanzverlusten bei revisionsonoperationen am Huftgelenk—mittelfristige Ergebnisse. Primare und revisionarthroplastik. Endo-Klinik, Hamburg. Springer, Berlin Heidelberg New York, pp 189–201
Gie GA, Linder L, Ling RS, Simon JP, Slooff TJJH, Timperley AJ (1993) Impacted cancellous allografts and cement for revision total hip arthroplasty. J Bone Joint Surg Br 75:14–21
Kärrholm J, Hultmark P, Carlsson L, Malchau H (1999) Subsidence of a non-polished stem in revisions of the hip using impaction allograft. J Bone Joint Surg Br 81:135–142
Kirchner PT, Simon MA (1981) Current concepts review radioisotopic evaluation of skeletal disease. J Bone Joint Surg Am 63:673–681
Lifeso RM, Abdel-Nabi M, Meinking C (1991) Triphasic bone scanning following porous-coated hip arthroplasty. Clin Orthop 269:38–42
Ling RSM, Timperley AJ, Linder L (1993) Histology of cancellous impaction grafting in the femur. J Bone Joint Surg Br 75:693–696
Maniar RN, Todd RC, Robinson S, Critchley M (1997) Uptake of99mTc-MDP after uncemented hip arthroplasty. J Bone Joint Surg Br 79:123–128
Mikhail WEM, Weidenhielm LRA, Wretengerg P, Mikhail MN, Bauer TW (1999) Femoral bone regeneration subsequent to impaction grafting during hip revision. J Arthroplasty 14:849–853
Mullaji AB, Todd RC, Robinson S et al (1994) Quantitative bone scanning after asymptomatic Charnley arthroplasty. Acta Orthop Scand 65:276–280
Nelissen RGHH, Bauer TW, Weidenhielm RA, Le Golvan DP, Mikhail WEM (1995) Revision hip arthroplasty with the use of cement and impaction grafting. J Bone Joint Surg Br 77:412–422
Rosenthall L, Ghazal ME, Brooks CE (1991) Quantitative analysis of radiophosphate uptakes in asymptomatic porous-coated hip endoprostheses. J Nucl Med 32:1391–1393
Suh KT, Lee CB, Kim IJ (2001) Natural progress of a bone scan after cementless hydroxyapatite-coated total hip arthroplasty. Clin Orthop 389:134–142
Tokgözoğlu AM, Aydin M, Atilla B, Caner B (2000) Scintigraphic evaluation of impaction grafting for total hip arthroplasty revision. Arch Orthop Trauma Surg 120:416–419
Ullmark G, Linder L (1998) Histology of the femur after cancellous impaction grafting using a Charnley prosthesis. Arch Orthop Trauma Surg 117:170–172
Weidenhielm LRA, Mikhail WEM, Wretengerg P, Fow J, Simpson J, Bauer TW (2001) Analysis of the retrieved hip after revision with impaction grafting. Acta Orthop Scand 72:609–614
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Hisatome, T., Yasunaga, Y., Takahashi, K. et al. Bone remodeling after impacted cancellous allograft in revision hip arthroplasty based on 99mTc-MDP bone scintigraphy. Arch Orthop Trauma Surg 124, 52–55 (2004). https://doi.org/10.1007/s00402-003-0589-6
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00402-003-0589-6