Impaction bone grafting with morselized bone in total hip revision for acetabular deficiency / 中国组织工程研究

BACKGROUND:Bone graft for acetabular reconstruction includes morselized bone graft, structural bone graft and hybrid bone graft, and the morselized bone has been widely used because of the advantages of simple production and short healing time. OBJECTIVE:To explore the key technologies and clinical effect of impaction bone grafting with morselized bone in total hip revision for AAOS Ⅲ acetabular deficiency. METHODS:Sixteen cases of AAOS Ⅲ acetabular deficiency were treated with impaction bone grafting with morselized bone combined with metal devicesor constructive bone grafting. The hip Harris scores and radiographic data were compared before and after treatment. The effect of impaction bone grafting with morselized bone on acetabular deficiency was assessed. RESULTS AND CONCLUSION:Al the patients were fol owed-up at 3, 6, 12 months after surgery and every half a year successively. The pain of hip joints after operation was relieved significantly and the walking function was restored. The hip Harris score was improved from 48.00 points before surgery to 84.94 points after surgery (Pacetabular cup prosthesis did not displaced, and no displacement and breakage happened to the metal devices. Impaction bone grafting with morselized bone in total hip revision for AAOS Ⅲ acetabular deficiency can effectively reconstruct the acetabular bone structure, retain and restore the acetabular bone mass, and it has good technical advantages and good clinical effects.

Open autologous minimal morselized bone grafting with vancomycin repairs infected tibial defects / 中国组织工程研究

10.3969/j.issn.2095-4344.2013.25.004

Treatment of Thoracolumbar Vertebrate Fracture by Transpedicular Morselized Bone Grafting in Vertebrae for Spinal Fusion and Pedicle Screw Fixation / 华中科技大学学报（医学）（英德文版）

To enhance the fusion of graft bone in thoracolumbar vertebrae and minimize the postoperative loss of correction, short-segment pedicle screw fixation was reinforced with posterior moselizee bone grafting in vertebrae for spinal fusion in patients with thoracrolumbar vertebrate fractures. Seventy patients with thoracrolumbar vertebrate fractures were treated by short-segment pedicle screw fixation and were randomly divided into two groups. Fractures in group A (n=20) were reinforced with posterior morselized bone grafting in vertebrae for spinal fusion, while patients group B (n=50) did not receive the morselized bone grafting for bone fusion. The two groups were compared in terms of kyphotic deformity, anterior vertebral height, instrument failure and neurological functions after the treatment. Frankel grading system was used for the evaluation of neurological evaluation and Denis scoring scale was employed for pain assessment. The results showed that the kyphosis correction was achieved in both group A and group B (group A: 6.4 degree; group B: 5.4 degree)/At the end of follow-up, kyphosis correction was maintained in group A but lost in group B (P=0.0001). Postoperatively, greater anterior height was achieved in group A than in group B (P<0.01). During follow-up study, anterior vertebral height was maintained only in Group A (P<0.001). Both group A and group B showed good Denis pain scores (P1 and P2) but group A outdid group B in terms of control of severe and constant pain (P4 and P5). By Frankel criteria, the changes in neurological functions in group A was better than those of group B (P<0.001). It is concluded that reinforcement of short-segment pedicle fixation with morselized bone grafting for the treatment of patients with thoracolumbar vertebrae fracture could achieve and maintain kyphosis correction, and it may also increase and maintain anterior vertebral height. Morselized bone grafting in vertebrae offers immediate spinal stability in patients with thoracolumbar vertebrate fractures, decreases the instrument failure and provides better postoperative pain control than without the morselized bone grafting.

Subtalar Arthrodesis using Cannulated Screws and Morselized Bone Graft / 대한족부족관절학회지

PURPOSE: To analyze the clinical and radiological outcome of subtalar arthrodesis using cannulated screws and morselized bone graft. MATERIALS AND METHODS: Twenty one patients with follow-up of more than 1 year after subtalar arthrodesis were included in this study. Mean age was 40.8 years, and mean follow-up duration was 38 months. Underlying diseases were 19 cases of posttraumatic arthritis (18 calcaneal fractures and 1 talar fracture) and 2 cases of tarsal coalition. Clinically AOFAS ankle-hindfoot score, operation time, complication and satisfaction of patients were analyzed. Radiologically time to union, arthritis of surrounding joints, preoperative and postoperative talar declination angle were analyzed. RESULTS: AOFAS ankle-hindfoot score was improved from preoperative 33 points to postooperative 79 points. Eighteen patients (86%) were satisfied with the results. Mean operation time was 91 minutes. All cases were fixed with 1-2 cannulated screws and morselized bone graft. Mean time to radiologic union was 12.1 weeks. There was 1 case of delayed union. There was no significant perioperative changes in talar declination angles. CONCLUSION: Subtalar arthrodesis using cannulated screws and morselized bone graft seems to be relatively simple and effective treatment method for subtalar arthritis.

Cementless Acetabular Revision Performed with Morselized Bone Grafts:A Ten-Year Minimum Follow-Up

Purpose: We evaluated the results of cementless acetabular revisions performed with morselized bone grafting and screw-fixed hemispherical cups with different surface treatments. Materials and Methods: Forty hips, which had been followed for more than 10 years, were included in this study. Reconstruction was performed with 10 hydroxyapatite (HA)-coated cups and 30 porocoated ones. The mean followup time was 12 years and 1 months (range, 10 years to 15 years). Re-revision or radiographic loosening was considered as an endpoint of follow-up. Results: The average Harris hip score improved from 52 points to 75 points. During the follow-up period, radiographic loosening was observed in 17 hips. The loosened implants were HA-coated cups in 8 hips and porocoated ones in 9 hips. In 14 of these, re-revision of the cups was performed. The re-revision rate was 20% for the porocoated cups and 80% for the HA-coated cups. There were 2 hips with liner wear, which had undergone liner and head changes. Bone grafts were united in all the hips. The average time to union was 5.2 months (range, 2 to 9 months), and the average time to incorporation was 12 months (range, 5 to 18 months). Conclusion: Our results imply that HA-coated cups have a significantly higher failure rate compared with the porocoated ones (P<0.05) after a minimum follow-up of 10 years. Morselized bone grafting with use of a porocoated cup is an effective modality, which can restore the bone loss of the acetabulum in revision total hip arthroplasty.

Experimental study of cervical interbody fusion with combined hollow threaded autograft fixator with morselized bone transplantation / 中国矫形外科杂志

[Objective]To study cervical hollow threaded autograft cortical bone fixator with morselized bone for cervical anterior interbody fusion.[Method] Eighteen sheep were underwent cervical anterior discectomy and fusion with a hollow threaded and fenestrated tibial cortical hone fixator filled with morselized bone(diameter of 300～500 um) for C5、6 or autogenous iliac crest bone cylinder or C3、4 respectively.Cervical spines were radiographed immediately after surgery and 1,2,3 months later,the specimens of C5～6 and C3～4 were taken for histology investigation and biomechanical test respectively.[Result] Interbody fusion was achieved 3 months after surgery in experimental gronp and all but one in control group,with statisticdly significant difference was found between two groups in biomechanical compression and torsion tests of ante or post-fatigue test(P

Titanium plate and morselized bone grafting for severe acetabular bone defect / 中国矫形外科杂志

[Objective]To explore the clinical effects of titanium plate and morselized hone grafting for the treatment of severe acetabular hone defect.[Method]A total of 27 patients with acetabular defects were treated with this procedure.According to AAOS,the acetabular defects were classified into various types:type Ⅰ in 6 cases,type Ⅱc in 4 and type Ⅲ in 17.The average preoperation Harris score were 37.The postoperative effect should be evaluated by clinical and X-ray manifestations.[Result]All patients were adopted this method to reconstruct the acetabular bone defects.The prosthetic dislocation was found in one case after operation,which was resulted from over-anteverted titanium plate impacted the greater trochanter.The part of trochanteric bone and impact factors were removed to healing.No complications were found in other patients.The average following up was 3 years and average Harris score was 87.The X-ray showed that none of the patients was presented the radiolucent lines in the acetabular mattress,bone transplantation,reconstructive titanium plate and interface of polyethylene liner.[Conclusion]The titanium plate and morselized bone grafting can repair the acetabular bone defects effectively and provide a solid initial fixation for prosthesis and restore the role of rotational center of hip.

Morselized bone grafting in osteolysis around the stable cenmentless acetabular cup / 中国矫形外科杂志

[Objective]To evaluate the clinical and radiological results of a curettage of granulation tissue,the exchange of polyethylene liner and morselized bone grafting for the treatment of osteolysis around a stable cementless acetabular cup.[Method]From Apr.1996 to Jul.2000,26 patients underwent revision of curettage of granulation tissue,the exchange of polyethylene liner and morselized allografting,which were followed up for an average of 5.5 years.The Harris Hip Score was used to evaluate the clinical result.The size of osteolysis of periacetabular cup was measured in AP and lateral view of X-rays.The allograft union was evaluated with the bone graft incorporation scale.[Result]Clinically,the average HHS increased from 82 to 88 points postoperatively.Radiologically,the size of osteolysis of peraacetabular cup changed from average 23.8 mm?24.9 mm to 11.5 mm?8.2 mm in the AP view,and from 11.1 mm?11.6 mm to 5.3 mm?4.5 mm in the lateral view.The bone graft incorporation scales were Grade Ⅰ and Ⅱ in 12 and 14 cases,respectively.[Conclusion]The Curettage of granulation tissues,morselized bone grafting and exchange of polyethylene liner and femoral head is an effective therapy in osteolysis around a stable cementless acetabular cup and could preserve the bone stock for the further revision THA.

Experimental study on repairing bone defect with the compound of the allogeneic morselized bone / 中国康复理论与实践

@#ObjectiveTo observe the effect of the compound of the allogeneic morselized bone and the calcium phosphate cement on repairing bone defect.MethodsThe rabbit models of bilateral radius bone defect were created. 40 rabbits were randomly divided into group A, group B and group C. Animals of the group A were implanted with the compound of the allogeneic morselized bone and the calcium phosphate cement, group B implanted with allogeneic morselized bone, and group C as blank control implanted nothing. The X-ray examination, histopatholgical examination, vascularization and biomechanics of bone defect were evaluated at 4 and 8 weeks after operation.ResultsThe repair of bone defect, quantity and rate of the new formation bone and biomechanics measurement of the group A were superior than the group B; while, no repair of bone defect was found in the group C.ConclusionThe implantation of the allogeneic morselized bone can repair bone defect, but the effect of implanting the compound of the allogeneic morselized bone and the calcium phosphate cement is better than the former.

Expression of basic fibroblast growth factor in ectopic osteogenesis of autogenetic minimal morselized bone / 中华创伤杂志

Objective To study the expression of basic fibroblast growth factor (bFGF) in ectopic osteogenesis of autogenetic minimal morselized bone so as to discuss the bone formation of minimal morselized bone. Methods All 48 rabbits were divided into two groups randomly. Then autogenetic minimal morselized bone and bulk bone were implanted into the muscle bag models of gluteus maximus muscle respectively. Samples were harvested on day 1,3,5,7,11,14,21 and 28 postoperatively and tested by the methods of histology, immunohistochemistry (IHC) and in situ hybridization (ISH). Results (1) The morselized bone grew faster than the bulk bone and was replaced by neonatal bone on the 28th day. In the group of bulk bone, the ability of osteogenesis was weaker dominated by bone absorption. (2) In the morselized bone group, the expression peaks of bFGF and bFGFmRNA appeared at day 5-7 postoperatively, mainly appeared in the mesenchymal cells, fibroblast, chondrocyte and osteoblast by the method of IHC and ISH. While in the group of bulk bone, the expressions of bFGF and bFGFmRNA were similar to those in the morselized bone group. The difference between the two groups was significant ( P