Fibrous tissue armoring increases the mechanical strength of an impacted bone graft
- 1 January 2001
- journal article
- research article
- Published by Medical Journals Sweden AB in Acta Orthopaedica
- Vol. 72 (1), 78-82
- https://doi.org/10.1080/000164701753606743
Abstract
Impacted, morselized bone allografts are used with good clinical results in revision of hip prostheses with loosening and osteolysis. The impacted bone graft appears radiographically to remodel, but histological analyses have shown a heterogeneous picture with a mixture of living and dead bone. Thus, complete remodeling of the graft may be neither a prerequisite nor a cause of the good clinical results. The present study concerns the mechanical effect of the mere armoring of the bone graft by ingrowing fibrous tissue. We compared the compression strength of freshly-impacted grafts to grafts that had been inserted into a bone chamber and thus were penetrated by fibrous tissue growing in between the graft trabeculae. The compressive strength was doubled after 4 weeks of fibrous ingrowth. We conclude that the mechanical properties of an impacted graft are enhanced by armoring with ingrowing fibrous tissue. Strengthening of the parts of the impacted grafts which have not yet remodeled, would be clinically relevant for the outcome of the operation, since these parts are at high stress during the whole remodeling period. Complete osseous remodeling may not be necessary to obtain a good clinical result with a morselized impacted graftKeywords
This publication has 15 references indexed in Scilit:
- Subsidence of a non-polished stem in revisions of the hip using impaction allograftThe Journal of Bone and Joint Surgery, 1999
- Mechanical behavior of human morselized cancellous bone in triaxial compression testingJournal of Orthopaedic Research, 1998
- Migration and wear of hydroxyapatite-coated press-fit cups in revision hip arthroplasty: A radiostereometric studyThe Journal of Arthroplasty, 1997
- The cement mantle in the exeter impaction allografting technique: A cause for concernThe Journal of Arthroplasty, 1997
- Massive early subsidence following femoral impaction graftingThe Journal of Arthroplasty, 1997
- Is staircase walking a risk for the fixation of hip implants?Journal of Biomechanics, 1995
- Revision hip arthroplasty with the use of cement and impaction grafting. Histological analysis of four cases.The Journal of Bone & Joint Surgery, 1995
- High failure rate of bulk femoral head allografts in total hip acetabular reconstructions at 10 yearsThe Journal of Arthroplasty, 1993
- Impacted cancellous allografts and cement for revision total hip arthroplastyThe Journal of Bone and Joint Surgery. British volume, 1993
- Instability of total hip prostheses at rotational stress: A roentgen stereophotogrammetric studyActa Orthopaedica, 1984