Fibrous tissue armoring increases the mechanical strength of an impacted bone graft

Acta Orthopaedica Scandinavica
Magnus Tägil, Per Aspenberg

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 graft.

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Citations

Jan 16, 2010·Cell and Tissue Banking·Iain R McNamara
Dec 31, 2003·Biomaterials·Pieter BumaNico Verdonschot
Apr 7, 2011·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Zheng-Jian XuRong-Xin He
Jan 31, 2002·Acta Orthopaedica Scandinavica·B W Schreurs, P Buma
Feb 7, 2004·Acta Orthopaedica Scandinavica·Magnus TägilPer Aspenberg
Jun 23, 2018·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Ola BelfrageGunnar Flivik
Aug 15, 2006·Clinical Orthopaedics and Related Research·Gerjon HanninkPieter Buma
Dec 5, 2006·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Anneliese D HeinerThomas D Brown
Jun 21, 2005·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Hanspeter FreiThomas R Oxland
Jul 3, 2004·Clinical Orthopaedics and Related Research·Stefan B T BolderPieter Buma
Mar 5, 2003·Clinical Orthopaedics and Related Research·Sanne van der DonkB Willem Schreurs
Sep 1, 2005·Clinical Orthopaedics and Related Research·J J Chris ArtsPieter Buma
Sep 3, 2004·The Journal of Bone and Joint Surgery. American Volume·Andrew D TomsJan Herman Kuiper
Jun 6, 2015·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Ena ColoBerend Willem Schreurs
Oct 3, 2003·Acta Orthopaedica Scandinavica·Charlotte JeppssonPer Aspenberg
Aug 1, 2006·The Journal of Bone and Joint Surgery. British Volume·U Kesteris, P Aspenberg
Mar 2, 2021·The Bone & Joint Journal·Eduardo Garcia-ReyEduardo Garcia-Cimbrelo

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