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Journal of Bone and Joint Surgery - British Volume, Vol 87-B, Issue 12, 1684-1687.
doi: 10.1302/0301-620X.87B12.16781  
Copyright © 2005 by British Editorial Society of Bone and Joint Surgery
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Histology of vancomycin-supplemented impacted bone allografts in revision total hip arthroplasty

M. A. Buttaro, MD, Orthopaedic Surgeon1; A. Morandi, MD, Pathology Department Chief1; H. Garcia Rivello, Pathologist1; and F. Piccaluga, MD, Hip Surgery Unit Chief, Orthopaedic Surgeon1

1 The Hip Surgery Unit Institute of Orthopaedics "Carlos E. Ottolenghi", Italian Hospital of Buenos Aires, Potosi 4215 (C1199ACK), Buenos Aires, Argentina.

Correspondence should be sent to Dr M. A. Buttaro; e-mail: cadera{at}hospitalitaliano.org.ar

Vancomycin-supplemented allografts provide biological restoration of bone stock and sound fixation with a low incidence of re-infection. Experimental incorporation of these grafts is similar to allografts without vancomycin. However, the underlying biology remains unknown.

We report the first histological observations of vancomycin-supplemented impacted bone allografts in two reconstructions performed 14 and 20 months after revision surgery because of a periprosthetic fracture.

Areas of active bone remodelling (creeping substitution), as well as calcified bone trabeculae and graft particles embedded in dense fibrous tissue, were observed with osteoid and fibroconnective tissue surrounding polymethylmethacrylate particles.

These pathological findings are similar to those reported in allografts without vancomycin and support the hypothesis that high levels of vancomycin do not affect the incorporation of bone graft.




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Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General