Is an Impacted Morselized Graft in a Cage an Alternative for Reconstructing Segmental Diaphyseal Defects?
Open Access
- 1 March 2009
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Clinical Orthopaedics and Related Research
- Vol. 467 (3), 783-791
- https://doi.org/10.1007/s11999-008-0686-5
Abstract
Large diaphyseal bone defects often are reconstructed with large structural allografts but these are prone to major complications. We therefore asked whether impacted morselized bone graft could be an alternative for a massive structural graft in reconstructing large diaphyseal bone defects. Defects in the femora of goats were reconstructed using a cage filled with firmly impacted morselized allograft or with a structural cortical autograft (n = 6 in both groups). All reconstructions were stabilized with an intramedullary nail. The goats were allowed full weightbearing. In all reconstructions, the grafts united radiographically. Mechanical torsion strength of the femur with the cage and structural cortical graft reconstructions were 66.6% and 60.3%, respectively, as compared with the contralateral femurs after 6 months. Histologically, the impacted morselized graft was replaced completely by new viable bone. In the structural graft group, a mixture of new and necrotic bone was present. Incorporation of the impacted graft into new viable bone suggests this type of reconstruction may be safer than reconstruction with a structural graft in which creeping substitution results in a mixture of viable and necrotic bone that can fracture. The data suggest that a cage filled with a loaded morselized graft could be an alternative for the massive cortical graft in reconstruction of large diaphyseal defects in an animal model.Keywords
This publication has 43 references indexed in Scilit:
- Impaction allografting in revision total hip replacementThe Journal of Bone and Joint Surgery. British volume, 2006
- Histology of Tissues Within Retrieved Human Titanium Mesh CagesSpine, 2003
- Acetabular Reconstruction With Bone Impaction Grafting and a Cemented CupClinical Orthopaedics and Related Research, 2001
- Autologous morsellised bone grafting restores uncontained femoral bone defects in knee arthroplastyThe Journal of Bone and Joint Surgery. British volume, 2000
- Morsellized bone allografting in revision total knee replacement--a case report with a 4-year histological follow-upActa Orthopaedica, 2000
- New segmental long bone defect model in sheep: Quantitative analysis of healing with dual energy X‐ray absorptiometryJournal of Orthopaedic Research, 1999
- Health status after Ilizarov reconstruction of post-traumatic lower-limb deformityThe Journal of Bone and Joint Surgery. British volume, 1998
- Biomechanical and histological evaluation of a hydroxyapatite-coated titanium femoral stem fixed with an intramedullary morsellized bone grafting technique: an animal experiment on goatsBiomaterials, 1996
- Impacted graft incorporation after cemented acetabular revision: Histological evaluation in 8 patientsActa Orthopaedica, 1996
- Morsellized allografts for fixation of the hip prosthesis femoral component: A mechanical and histological study in the goatActa Orthopaedica, 1994