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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 9, 1164-1171.
doi: 10.1302/0301-620X.90B9.20425  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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Acetabular bone reconstruction in revision arthroplasty

A COMPARISON OF FREEZE-DRIED, IRRADIATED AND CHEMICALLY-TREATED ALLOGRAFT VITALISED WITH AUTOLOGOUS MARROW VERSUS FROZEN NON-IRRADIATED ALLOGRAFT

B. G. Ochs, MD, Orthopaedic Registrar1; U. Schmid, MD, Orthopaedic Surgeon2; J. Rieth, Medical Student1; A. Ateschrang, MD, General Surgeon1; K. Weise, MD, Professor, Orthopaedic Surgeon1; and U. Ochs, MD, Consultant Orthopaedic Surgeon1

1 BG Trauma Centre, University of Tuebingen, Schnarrenbergstrasse 95, 72076 Tuebingen, Germany.
2 Department for Hand Surgery, Vulpius Clinic, Vulpiustrasse 94, 74906 Bad Rappenau, Germany.

Correspondence should be sent to Dr B. G. Ochs; e-mail: ochsgunnar{at}gmx.de

Deficiencies of acetabular bone stock at revision hip replacement were reconstructed with two different types of allograft using impaction bone grafting and a Burch-Schneider reinforcement ring. We compared a standard frozen non-irradiated bone bank allograft (group A) with a freeze-dried irradiated bone allograft, vitalised with autologous marrow (group B). We studied 78 patients (79 hips), of whom 87% (69 hips) had type III acetabular defects according to the American Academy of Orthopaedic Surgeons classification at a mean of 31.4 months (14 to 51) after surgery. At the latest follow-up, the mean Harris hip score was 69.9 points (13.5 to 97.1) in group A and 71.0 points (11.5 to 96.5) in group B. Each hip showed evidence of trabeculation and incorporation of the allograft with no acetabular loosening.

These results suggest that the use of an acetabular reinforcement ring and a living composite of sterile allograft and autologous marrow appears to be a method of reconstructing acetabular deficiencies which gives comparable results to current forms of treatment.




eLetters:

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Bone marrow does not improve osteoinductivity of allografts
Heinz Winkler
J Bone Joint Surg Br Online, 17 Oct 2008 [Full text]

(c) British Editorial Society of Bone and Joint Surgery All Rights Reserved
Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General