title: Microscopic analysis of autograft bone applied at the interface of porous-coated devices in human cancellous bone.
abstract: This study describes the response of human cancellous bone when autologous bone chips are added at operation to the interface between host bone and porous-coated implants. During the first operation of a staged bilateral total knee arthroplasty, seven patients consented to have paired porous-coated devices implanted into their opposite medial femoral condyle. One device of each pair had autologous bone chips applied to the porous-coating, and the other was not grafted and was a control. The devices were removed en bloc at the second total knee arthroplasty 6 to 49 weeks later. Backscattered electron imaging showed significantly more bone (p < or = 0.05) in the porous-coating of the implant treated with autologous bone chips which significantly increased (p < or = 0.05) the amount of bone available at the interface. The grafted devices had a mineral apposition rate of 1.04 +/- 0.20 microns/day for the interface and 0.81 +/- 0.09 microns/day for the peripheral bone. This compared with corresponding figures of 1.03 +/- 0.38 microns/day and 0.79 +/- 0.19 microns/day at the ungrafted devices. The mineral apposition rate at the interface of the porous-coated implants was significantly increased (p < or = 0.05) relative to the host bone in the periphery. Our results support the view that autologous bone chips are effective in attaching cementless porous-coated total knee replacements to the human skeleton by bone ingrowth.
authors: Orthopedics Section, Veterans Affairs Medical Center, Salt Lake City, UT 84148.
authors: A A
authors: AA
authors: Hofmann
authors: R D
authors: RD
authors: Bloebaum
authors: M H
authors: MH
authors: Rubman
authors: K N
authors: KN
authors: Bachus
authors: R L
authors: RL
authors: Plaster
mesh_terms: D000368:Aged; D015519:Bone Density; D016025:Bone Transplantation; D001842:Bone and Bones / Q000473:pathology; D006801:Humans; D007720:Knee Prosthesis / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016348:Osseointegration; D014182:Transplantation, Autologous