Effects of grafting on porous metal ingrowth. A canine model.

Twenty-five mongrel dogs were studied using implantation of autograft, fresh-frozen allograft, and beta-tricalcium phosphate around a porous-coated chrome-cobalt plug in the distal femoral metaphysis; interference-fit and overreamed control specimens were also studied. Over the course of this 4-month study, bone ingrowth through the grouting materials into the center plug was noted for autologous, allograft, and ceramic specimens. Quantitatively, in terms of push-out strength and histology, there were no significant differences between grafted groups; significantly higher push-out strengths were attained in each grafted subgroup compared with nongrafted, overreamed control subjects. In the setting of uncemented revision total hip arthroplasty, bone-grafting is frequently required. Because of the limited availability of autogenous bone and the potential liabilities of allograft material, attention has been given to bone substitutes. On the basis of this preliminary study, bone ingrowth into a porous metal substrate has been documented to occur through autograft, allograft, or ceramic grouting agents. Within the limits of this nonloaded experimental model, it appears that these materials are comparable in terms of their osteoconductive capability. Even in the optimal laboratory situation, bone ingrowth does not appear to occur in a canine model across a nongrafted 2-mm gap with regularity over a 16-week period.