Results of treatment of aseptic loosening of hip prostheses using frozen spongy bone allografts.

BACKGROUND: [corrected] The authors present the results of treatment of aseptic loosening of hip prostheses using frozen allogenic spongy bone grafts. MATERIAL AND METHODS: 34 patients (8 men and 26 women) between 34 and 79 years of age were evaluated. These patients all underwent revision hip arthroplasty during the period from 1995 to 1998. Surgical treatment using frozen spongy bone grafts was performed on patients with defects of the acetabulum and femur after loosening of hip prostheses. In each case bone grafts were used for acetabular and femoral reconstruction. To evaluate the progress of graft incorporation, radiological examinations were made at 6 weeks, 3 months, 6 months, 1 year and 2 years after the date of surgery. We observed the process of calcification abilities of the reconstructed structures were evaluated according to the Merle d'Aubigne-Postel scale. RESULTS: In all cases the spongy bone grafts were reconstructed and rebuilt successfully. 24 patients had good results in further clinical examinations. We argue that frozen allogenic grafts of spongy bone are very useful in filling acetabular and femoral defects in aseptic loosening of hip prostheses. CONCLUSIONS: This method of treatment provides good results and should recommended.

Application of frozen and radiation-sterilised bone allografts for treatment of bone cysts.

Between 1981 and 1998 frozen and radiation sterilized bone allografts were transplanted into 1376 patients at the Institute of Traumatology, Orthopaedic and Neurosurgery of the Military School of Medicine in Warsaw. Of these 179 (13%) required treatment due to benign tumours. Incidence of solitary cysts was highest (127 cases, 71%), mainly occurring in children (84%). During surgery bone cysts were excised and filled by bone grafts. Results were evaluated several years after surgery (2-10 yrs) using x-rays and clinical examination. Rebuilding of allografts was one of the most important prognostic factors. Within the period of observation time 83% of transplanted allografts were rebuilt and substituted by own patients bone.

The usage of frozen allografts of the spongy bone in filling the loss of bone after loosening of the hip prosthesis.

The authors present the way of using allogenic, frozen, radio-sterilizated, spongy bone grafts in operational reconstructing the defects of bone stock caused by loosening of the hip prosthesis. The bone grafts were sterelizated by radiation, formed in cubes and it had the fat removed. The operational reconstruction of the spongy bone was performed according to the method described by E. Gee, R. Ling and T.J.J.H. Sioof. Thirty five operations of the revision hip arthroplasty with using the bone grafts were made since 1995. Just before transplantation the grafts were morselised to pieces of size 3 x 3 x 3 mm and then stuck in the place of the defect. Rebuilding of the morselised grafts of the spongy bone starts from activating osteoblasts, while the same process in the compact bone starts with osteolysis by activating osteoclasts. The mechanical durability of these grafts is also very high. We claim that the biological connection between the host bone and the graft forms in a couple of weeks, but the forming of a solid, fully functional bone takes about few months. Only radiological examination shows the stage of allografts incorporation into host's skeleton. Between these 35 operations 2 patients needed to be operated again, because of the grafts resorption. In conclusion, operative revision hip arthroplasty to require the special operating tools large quantities spongy bone allografts.