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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 2, 228-231.
doi: 10.1302/0301-620X.90B2.19921  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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Viability of impacted bone allografts under metal mesh at the calcar in revision surgery of the hip

M. Buttaro, MD, Orthopaedic Surgeon1; G. S. Araujo, MD, Orthopaedic Resident1; E. S. Araujo, MD, Professor2; F. Comba, MD, Orthopaedic Surgeon1; and F. Piccaluga, MD, Hip Surgery Unit Chief, OrthopaedicSurgeon1

1 The Hip Surgery Unit. Institute of Orthopaedics, "Carlos E. Ottolenghi" Italian Hospital of Buenos Aires, Potosi 4215 (C1199ACK), Buenos Aires, Argentina.
2 Orthopaedic Pathology, Bone Pathology Laboratory, Paraguay 2301 (C1425), Buenos Aires, Argentina.

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

Metal meshes are used in revision surgery of the hip to contain impacted bone grafts in cases with cortical or calcar defects in order to provide rotational stability to the stem. However, the viability of bone allografts under these metal meshes has been uncertain.

We describe the histological appearances of biopsies obtained from impacted bone allografts to the calcar contained by a metal mesh in two femoral reconstructions which needed further surgery at 24 and 33 months after the revision procedure.

A line of osteoid and viable new bone was observed on the surface of necrotic trabeculae. Active bone marrow between these trabeculae showed necrotic areas in some medullary spaces with reparative fibrous tissue and isolated reactive lymphocytes. This is interpreted as reparative changes after revascularisation of the cancellous allografts.

These pathological findings are similar to those reported in allografts contained by cortical host bone and support the hypothesis that incorporation of morcellised bone under metal meshes is not affected by these devices.






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