Impaction bone grafting with hydroxyapatite: increased femoral component stability in experiments using Sawbones.
BACKGROUND
Substantial bone loss and bone defects increase the amount of allografting required in hip revision surgery. Thus, the use of a synthetic material to limit the amount of allograft tissue required for impaction grafting is desirable. We evaluated the potential of hydroxyapatite (HA) mixtures to provide initial mechanical stability to a polished tapered femoral stem.


METHODS
We determined the initial stability of a polished tapered femoral stem after reconstructing a cavitary femoral bone defect by impaction bone grafting with cement in Sawbones composite femurs. Three types of graft material were tested for their ability to improve initial rotational stability. The graft materials investigated were pure allograft, a mixture of 50% allograft and 50% hydroxyapatite (HA), and pure HA.


RESULTS
We found a statistically significant difference between the three groups as regards torsional micromotion and failure load.


CONCLUSIONS
Our findings suggest that reconstruction of femoral bone defects with pure HA or a mixture of allograft and HA provides adequate initial stability for femoral revision arthroplasty using impaction grafting.
Fujishiro
Takaaki
T
Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Japan. taka2446@yg8.so-net.ne.jp
Nishikawa
Tetsuo
T
Niikura
Takahiro
T
Takikawa
Satoshi
S
Nishiyama
Takayuki
T
Mizuno
Kiyonori
K
Yoshiya
Shinichi
S
Kurosaka
Masahiro
M
D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D001696:Biomechanical Phenomena; D018786:Bone Substitutes; D016025:Bone Transplantation / Q000379:methods*; D005269:Femur / Q000601:surgery; D006801:Humans; D006882:Hydroxyapatites; D011475:Prosthesis Failure; D012086:Reoperation; D014182:Transplantation, Autologous; D014183:Transplantation, Heterologous
D018786:Bone Substitutes; D006882:Hydroxyapatites