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Journal of Bone and Joint Surgery - British Volume, Vol 87-B, Issue 2, 267-271.
doi: 10.1302/0301-620X.87B2.14749  
Copyright © 2005 by British Editorial Society of Bone and Joint Surgery
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Tricalcium-phosphate and hydroxyapatite bone-graft extender for use in impaction grafting revision surgery

AN IN VITRO STUDY ON HUMAN FEMORA

E. H. van Haaren, MD, Research Fellow1; T. H. Smit, PhD, Biomechanical Engineer2; K. Phipps, MEng, Biomechanical Engineer3; P. I. J. M. Wuisman, MD, PhD, Orthopaedic Surgeon1; G. Blunn, PhD, Biomechanical Engineer3; and I. C. Heyligers, MD, PhD, Orthopaedic Surgeon1

1 Department of Orthopaedic Surgery, Skeletal Tissue Engineering Group Amsterdam (STEGA)
2 Department of Physics and Medical Technology STEGA Vrije Universiteit Medical Centre, P O Box 7057, 1007 MB Amsterdam, The Netherlands.
3 The Centre for Biomedical Engineering, Institute of Orthopaedics and Musculo-Skeletal Science, University College London, RNOH Trust, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK.

Correspondence should be sent to Dr I. C. Heyligers at Department of Orthopaedic Surgery, Atrium Medical Centre, P O Box 4446, 6401 CX Heerlen, The Netherlands; e-mail: heyligers{at}atriummc.nl

Impacted morsellised allografts have been used successfully to address the problem of poor bone stock in revision surgery. However, there are concerns about the transmission of pathogens, the high cost and the shortage of supply of donor bone. Bone-graft extenders, such as tricalcium phosphate (TCP) and hydroxyapatite (HA), have been developed to minimise the use of donor bone. In a human cadaver model we have evaluated the surgical and mechanical feasibility of a TCP/HA bone-graft extender during impaction grafting revision surgery.

A TCP/HA allograft mix increased the risk of producing a fissure in the femur during the impaction procedure, but provided a higher initial mechanical stability when compared with bone graft alone. The implications of the use of this type of graft extender in impaction grafting revision surgery are discussed.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General