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Femoral and acetabular revision using impacted nondemineralized freeze-dried bone allografts

  • Original Article
  • Published:
Journal of Orthopaedic Science

Abstract

Background

Favorable results have been obtained by the use of deep-frozen bone allografts in total hip arthroplasty. However, owing to the shortage of deep-frozen allografts and the risk of infectious disease, other materials have been studied, such as sterile nondemineralized freeze-dried allografts. The aim of this study was to describe midterm clinical outcomes and radiographic bone incorporation of human freeze-dried bone grafts in 42 revision total hip arthroplasty procedures using cancellous impacted bone grafting.

Methods

This report presented clinical and radiographic evidence of allograft incorporation in 42 hip reconstructions performed between 1996 and 2002. The patient group included 13 (31%) men and 29 (69%) women with mean ± SD age of 63 ± 14 years (range 28–80 years). Meanfollow-upwas 82 months (range 63–127) months. Clinical analysis was based on the D’Aubigné-Postel score. Radiographic incorporation was defined according to specific criteria.

Results

The D’Aubigné and Postel criteria showed adequate outcome in 38 (90%) of the patients. The radiographic evaluation revealed that allograft remodeling and incorporation were found in 39 (93.0%) and 36 (86.5%) of acetabular and femoral cases, respectively. The overall graft survival rate at an average follow-up of 8 years (range 5–10 years) was 90%.

Conclusions

Bone grafts obtained by the lyophilization process developed and carried out in our tissue bank provide suitable grafts for revision total hip arthroplasty. Clinical and radiographic midterm results were excellent, indicating that nondemineralized freeze-dried bone allografts are suitable for replacing deep-frozen grafts.

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References

  1. Macedo CA, Galia CR, Valin MR, Rosito R, Timm H, Müller LM. Uso de reforço acetabular em artroplastia total de quadril. Rev Bras Ortop 1998;33:307–314 (in Portuguese).

    Google Scholar 

  2. Finkemeier CG. Bone-grafting and bone-graft substitutes. J Bone Joint Surg Am 2002;84:454–464.

    PubMed  Google Scholar 

  3. McCollum DE, Nunley JA, Harrelson JM. Bone-grafting in total hip replacement for acetabular protrusion. J Bone Joint Surg Am 1980;62:1065–1073.

    PubMed  CAS  Google Scholar 

  4. Gates HS 3rd, McCollum DE, Poletti SC, Nunley JA. Bonegrafting in total hip arthroplasty for protrusio acetabuli: a followup note. J Bone Joint Surg Am 1990;72:248–251.

    PubMed  Google Scholar 

  5. Gie GA, Linder L, Ling RS, Simon JP, Slooff TJ, Timperley AJ. Impacted cancellous allografts and cement for revision total hip arthroplasty. J Bone Joint Surg Br 1993;75:14–21.

    PubMed  CAS  Google Scholar 

  6. Kershaw CJ, Atkins RM, Dodd CA, Bulstrode CJ. Revision total hip arthroplasty for aseptic failure: a review of 276 cases. J Bone Joint Surg Br 1991;73:564–568.

    PubMed  CAS  Google Scholar 

  7. Centers for Disease Control and Prevention (CDC). Update: allograft-associated bacterial infections — United States, 2002. MMWR Morb Mortal Wkly Rep 2002;51:207–210.

    Google Scholar 

  8. Kakiuchi M, Ono K, Nishimura A, Shiokawa H. Preparation of bank bone using defatting, freeze-drying and sterilisation with ethylene oxide gas. Part 1. Experimental evaluation of its efficacy and safety. Int Orthop 1996;20:142–146.

    Article  PubMed  CAS  Google Scholar 

  9. Schreurs BW, Slooff TJ, Buma BM, Gardeniers JW, Huiskes R. Acetabular reconstruction with impacted morsellised cancellous bone graft and cement: a 10- to 15-year follow-up of 60 revision arthroplasties. J Bone Joint Surg Br 1998;80:391–395.

    Article  PubMed  CAS  Google Scholar 

  10. d’Aubigné RM, Postel M. Functional results of hip arthroplasty with acrylic prosthesis. J Bone Joint Surg Am 1954;36:451–475.

    PubMed  Google Scholar 

  11. D’Antonio JA, Capello WN, Borden LS, Bargar WL, Bierbaum BF, Boettcher WG, et al. Classification and management of acetabular abnormalities in total hip arthroplasty. Clin Orthop 1989;243:126–137.

    PubMed  Google Scholar 

  12. Engelbrecht E, Heinert K. Klassifikation und behandlungsrichtungen von knochen-substansverlusten bei revisionoperationen am huftgelenk. In: Mittelfristige ergebnisse: primare und revionsarthroplastik-Endo-Klinik. Berlin: Springer; 1987. p. 189–200 (in German).

    Google Scholar 

  13. DeLee JG, Charnley J. Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop 1976;121:20–32.

    PubMed  Google Scholar 

  14. Gruen TA, McNeice GM, Amstutz HC. “Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop 1979;141:17–27.

    PubMed  Google Scholar 

  15. Boldt JG, Dilawari P, Agarwal S, Drabu KJ. Revision total hip arthroplasty using impaction bone grafting with cemented nonpolished stems and Charnley cups. J Arthroplasty 2001;16:943–952.

    Article  PubMed  CAS  Google Scholar 

  16. Levai JP, Boisgard S. Acetabular reconstruction in total hip revision using a bone graft substitute: early clinical and radiographic results. Clin Orthop 1996;330:108–114.

    Article  PubMed  Google Scholar 

  17. Macedo CA, Galia CR, Silva AL, de César PC, Sanches PR, Duarte LS, et al. Comparação da resistência à compressão do osso bovino congelado e liofilizado. Rev Bras Ortop 19 1999;34:529–534 (in Portuguese).

    Google Scholar 

  18. Cornu O, Bavadekar A, Godts B, Van Tomme J, Delloye C, Banse X. Impaction bone grafting with freeze-dried irradiated bone. Part I. Femoral implant stability: cadaver experiments in a hip simulator. Acta Orthop Scand 2003;74:547–552.

    Article  PubMed  Google Scholar 

  19. Thien TM, Welten ML, Verdonschot N, Buma P, Yong P, Schreurs BW. Acetabular revision with impacted freeze-dried cancellous bone chips and a cemented cup: a report of 7 cases at 5 to 9 years’ follow-up. J Arthroplasty 2001;16:666–670.

    Article  PubMed  CAS  Google Scholar 

  20. De Roeck NJ, Drabu KJ. Impaction bone grafting using freezedried allograft in revision hip arthroplasty. J Arthroplasty 2001;16:201–206.

    Article  PubMed  Google Scholar 

  21. Zasacki W. The efficacy of application of lyophilized, radiation-sterilized bone graft in orthopedic surgery. Clin Orthop 1991;272:82–87.

    PubMed  Google Scholar 

  22. Lind M, Krarup N, Mikkelsen S, Hørlyck E. Exchange impaction allografting for femoral revision hip arthroplasty: results in 87 cases after 3.6 years’ follow-up. J Arthroplasty 2002;17:158–164.

    Article  PubMed  Google Scholar 

  23. Taylor DM. Inactivation of the BSE agent. Dev Biol Stand 1991;75:97–102.

    PubMed  CAS  Google Scholar 

  24. Aranda-Anzaldo A, Viza D, Busnel RG. Chemical inactivation of human immunodeficiency virus in vitro. J Virol Methods 1992;37:71–81.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedics, Hospital de Clínicas de Porto Alegre (HCPA), University Hospital Tissue Bank, Rua Ramiro Barcelos 2350, 90035-003, Porto Alegre, RS, Brazil

    Carlos Roberto Galia, Carlos Alberto De Souza Macedo & Ricardo Rosito

  2. Graduate Program in Surgery, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil

    Carlos Roberto Galia, Diane Ruschel Marinho & Luis Fernando Moreira

  3. HCPA University Hospital Tissue Bank, Porto Alegre, RS, Brazil

    Lourdes Maria Araújo Quaresma Camargo

  4. Marquês do Pombal 250/502, 90450-000, Porto Alegre, RS, Brazil

    Carlos Roberto Galia

Authors
  1. Carlos Roberto Galia
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  2. Carlos Alberto De Souza Macedo
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  3. Ricardo Rosito
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  4. Lourdes Maria Araújo Quaresma Camargo
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  5. Diane Ruschel Marinho
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  6. Luis Fernando Moreira
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Galia, C.R., De Souza Macedo, C.A., Rosito, R. et al. Femoral and acetabular revision using impacted nondemineralized freeze-dried bone allografts. J Orthop Sci 14, 259–265 (2009). https://doi.org/10.1007/s00776-009-1322-2

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  • DOI: https://doi.org/10.1007/s00776-009-1322-2

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