Effect of bone marrow grafting on the titanium porous-coated implant in bilateral total knee arthroplasty.
OBJECTIVE
Poor bone ingrowth into the porous coating of tibial components has been reported. We hypothesized that iliac marrow grafting might be useful to enhance bone ingrowth into a porous-coated implant. The first part of this study was to examine the presence of fibroblast colony-forming units (CFUF) containing osteogenic precursor cells in tibial bone marrow and iliac bone marrow. The second aim was to compare the clinical and radiographic results after bilateral total knee arthroplasty (TKA) with and without autologous bone marrow transplantation to the bone-implant interface.


METHODS
Simultaneous bilateral TKA was performed in 21 patients with osteoarthritis. Aspirated iliac bone marrow was transplanted to the interface of one randomly selected porous-coated tibial component in each patient, and contralateral knees served as controls. All of the 21 patients were followed for 5 years.


RESULTS
The average number of CFU-F was significantly lower in tibial marrow than in iliac marrow (p = 0.008). The final fluoroscopically-guided radiographs revealed a decrease in the number of knees with radiolucent lines after marrow grafting compared to those without grafting (p = 0.004).


CONCLUSIONS
Iliac bone marrow is useful as a bone grafting material to enhance the biological fixation in porous-coated implants.
Kim
Kang Jung
KJ
Department of Orthopaedic Surgery, Tokyo Women's Medical College, Tokyo, Japan. kkim@ort.twmu.ac.jp
Iwase
Miho
M
Kotake
Shigeru
S
Itoh
Tatsuo
T
D019645:Arthroplasty, Replacement, Knee; D016026:Bone Marrow Transplantation; D020099:Coated Materials, Biocompatible; D003114:Colony-Forming Units Assay; D005260:Female; D005347:Fibroblasts / Q000166:cytology; D005500:Follow-Up Studies; D006801:Humans; D007085:Ilium / Q000166:cytology; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000601:surgery; D011474:Prosthesis Design; D011859:Radiography; D013977:Tibia / Q000166:cytology; D014025:Titanium; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D020099:Coated Materials, Biocompatible; D014025:Titanium