BACKGROUND: The aim of this study was to present our clinical outcomes and surgical technique in strut allografts preparation using staggered holes to enhance osteointegration and demineralised bone matrix (DBM) as an adjunct to cortical strut allografts in salvage revision arthroplasty patients. METHODS: Retrospective consecutive series of patients who required strut allograft femoral reconstructions with minimum 2 years follow up between 2012 and 2018. Frozen washed irradiated, cortical struts were used and prepared adding 2 mm staggered drill holes along the length of the strut and applying DBM paste on the graft-host interface. Outcome measures included radiographic strut union, graft resorption, infection and complications. RESULTS: 15 patients included; 3 males and 12 females with median age 72 years (range 60-93). All had significant bony defects (Paprosky III/IV in 12 cases including 3 cases of periprosthetic hip fractures and further 3 cases of periprosthetic knee fractures around revision hinged implants). At final follow up, median 3.8 years (range 2.7-7.2), 14/15 (93.3%) struts had united at a median 6 months (range 5-8), complete incorporation with cortical round-off was seen at median 12 months (range 8-48) in 12/15 (80%) struts, 2/15 (13.3%) show radiographic evidence of proximal minimal graft resorptions although the remainder of the strut had integrated and were asymptomatic. There were no cases of infection. CONCLUSIONS: Use of strut allografts helps to reconstruct bone defects, restore bone stock, and provide stable fixation for complex patterns of periprosthetic fractures around hip/knee implants and salvage revision cases with 93.3% union rate at median 6 months.
BACKGROUND: The aim of this study was to present our clinical outcomes and surgical technique in strut allografts preparation using staggered holes to enhance osteointegration and demineralised bone matrix (DBM) as an adjunct to cortical strut allografts in salvage revision arthroplasty patients. METHODS: Retrospective consecutive series of patients who required strut allograft femoral reconstructions with minimum 2 years follow up between 2012 and 2018. Frozen washed irradiated, cortical struts were used and prepared adding 2 mm staggered drill holes along the length of the strut and applying DBM paste on the graft-host interface. Outcome measures included radiographic strut union, graft resorption, infection and complications. RESULTS: 15 patients included; 3 males and 12 females with median age 72 years (range 60-93). All had significant bony defects (Paprosky III/IV in 12 cases including 3 cases of periprosthetic hip fractures and further 3 cases of periprosthetic knee fractures around revision hinged implants). At final follow up, median 3.8 years (range 2.7-7.2), 14/15 (93.3%) struts had united at a median 6 months (range 5-8), complete incorporation with cortical round-off was seen at median 12 months (range 8-48) in 12/15 (80%) struts, 2/15 (13.3%) show radiographic evidence of proximal minimal graft resorptions although the remainder of the strut had integrated and were asymptomatic. There were no cases of infection. CONCLUSIONS: Use of strut allografts helps to reconstruct bone defects, restore bone stock, and provide stable fixation for complex patterns of periprosthetic fractures around hip/knee implants and salvage revision cases with 93.3% union rate at median 6 months.
Authors: Giuseppe Rollo; Enrico Maria Bonura; Gazi Huri; Mario Ronga; Christian Carulli; Michele Bisaccia; Francesco Traina; Paolo Pichierri; Marco Filipponi; Marco Giaracuni; Danilo Leonetti; Luigi Meccariello Journal: Med Glas (Zenica) Date: 2020-02-01
Authors: Robert S OʼConnell; John R Owen; Erik J Hansen; Azhar S Bashir; Jennifer S Wayne; Jibanananda Satpathy; Stephen L Kates Journal: J Orthop Trauma Date: 2018-10 Impact factor: 2.512
Authors: Marco De Gori; Guido Scoccianti; Filippo Frenos; Leonardo Bettini; Filippo Familiari; Giorgio Gasparini; Giovanni Beltrami; Pierluigi Cuomo; Pietro De Biase; Rodolfo Capanna Journal: Biomed Res Int Date: 2016-12-05 Impact factor: 3.411