The Role of Vibration and Drainage in Femoral Impaction Bone Grafting

Bone and Joint Research Group, Developmental Origins of Health and Disease, University of Southampton, Southampton, United Kingdom.
The Journal of arthroplasty (Impact Factor: 2.67). 05/2008; 23(8):1157-64. DOI: 10.1016/j.arth.2007.10.011
Source: PubMed


Vibration is commonly used in civil engineering applications to efficiently compact aggregates. This study examined the effect of vibration and drainage on bone graft compaction and cement penetration in an in vitro femoral impaction bone grafting model with the use of 3-dimensional micro-computed tomographic imaging. Three regions were analyzed. In the middle and proximal femoral regions, there was a significant increase in the proportion of bone grafts with a reciprocal reduction in water and air in the vibration-assisted group (P < .01) as compared with the control group, suggesting tighter graft compaction. Cement volume was also significantly reduced in the middle region in the vibration-assisted group. No difference was observed in the distal region. This study demonstrates the value of vibration and drainage in bone graft compaction, with implications therein for clinical application and outcome.

Download full-text


Available from: Richard O C Oreffo
  • [Show abstract] [Hide abstract]
    ABSTRACT: Excessive stem migration is often problematic after impaction allografting. The mechanisms responsible for migration are not known, but achieving a dense graft bed has traditionally been believed to be essential for stem stability. When the stem is cemented into the allograft bed, however, the graft becomes infiltrated with bone cement. Extensive cement penetration into the graft has been observed in previous studies, resulting in regions of cement-endosteum contact. This study explored the effects of graft density and cement penetration on stem motion using a finite element model that was validated against experimental data. Cement penetration has a considerable stabilizing effect on stem motion, whereas graft density is important only when there is no cement-endosteum contact. Stem migration can be attributed primarily to slippage at the endosteum and stem-cement interfaces rather than to shear failure within the graft. Partial cement penetration to the endosteum increases the likelihood of meeting clinical requirements of early implant stability, particularly when a dense graft bed cannot be achieved.
    No preview · Article · Oct 2009 · Clinical biomechanics (Bristol, Avon)
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The number of grafting procedures, including those performed in primary and revision hip arthroplasty, continues to rise around the world. Demand for musculoskeletal donor tissue now outstrips supply. There is no single bone substitute that is ideal for all circumstances. Bone substitutes act as a scaffold and are usually osteoconductive. They are rarely osteoinductive; if they are, a molecular bond is formed between the graft and host bone, improving fixation and longevity. Bone graft substitutes are very rarely osteogenic. There is a growing body of clinical evidence supporting the use of bone graft substitutes in vivo for complex hip arthroplasty.
    Full-text · Article · Dec 2009 · Materials
  • [Show abstract] [Hide abstract]
    ABSTRACT: Joint replacement surgery can have excellent clinical results. However, as the number of patients undergoing surgery increases, the number of failed joint replacements is set to rise. One of the greatest challenges for the revision surgeon is the restoration of bone stock. This article focuses upon revision hip surgery, with particular reference to the scope of the problem; historical and current solutions to bone loss in the femur and acetabulum; the clinical results following revision surgery; and the basic science behind impaction bone grafting, before ending with possible future directions for improving the restoration of bone stock.
    No preview · Article · Feb 2010 · Cell and Tissue Banking
Show more