Fibrous tissue armoring increases the mechanical strength of an impacted bone graft

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Fibrous tissue armoring increases the mechanical strength of an impacted bone graft. / Tägil, Magnus; Aspenberg, Per.

In: Acta Orthopaedica Scandinavica, Vol. 72, No. 1, 2001, p. 78-82.

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TY - JOUR

T1 - Fibrous tissue armoring increases the mechanical strength of an impacted bone graft

AU - Tägil, Magnus

AU - Aspenberg, Per

PY - 2001

Y1 - 2001

N2 - Impacted, morselized bone allografts are used with good clinical results in revision of hip prostheses with loosening and osteolysis. The impacted bone graft appears radiographically to remodel, but histological analyses have shown a heterogeneous picture with a mixture of living and dead bone. Thus, complete remodeling of the graft may be neither a prerequisite nor a cause of the good clinical results. The present study concerns the mechanical effect of the mere armoring of the bone graft by ingrowing fibrous tissue. We compared the compression strength of freshly-impacted grafts to grafts that had been inserted into a bone chamber and thus were penetrated by fibrous tissue growing in between the graft trabeculae. The compressive strength was doubled after 4 weeks of fibrous ingrowth. We conclude that the mechanical properties of an impacted graft are enhanced by armoring with ingrowing fibrous tissue. Strengthening of the parts of the impacted grafts which have not yet remodeled, would be clinically relevant for the outcome of the operation, since these parts are at high stress during the whole remodeling period. Complete osseous remodeling may not be necessary to obtain a good clinical result with a morselized impacted graft.

AB - Impacted, morselized bone allografts are used with good clinical results in revision of hip prostheses with loosening and osteolysis. The impacted bone graft appears radiographically to remodel, but histological analyses have shown a heterogeneous picture with a mixture of living and dead bone. Thus, complete remodeling of the graft may be neither a prerequisite nor a cause of the good clinical results. The present study concerns the mechanical effect of the mere armoring of the bone graft by ingrowing fibrous tissue. We compared the compression strength of freshly-impacted grafts to grafts that had been inserted into a bone chamber and thus were penetrated by fibrous tissue growing in between the graft trabeculae. The compressive strength was doubled after 4 weeks of fibrous ingrowth. We conclude that the mechanical properties of an impacted graft are enhanced by armoring with ingrowing fibrous tissue. Strengthening of the parts of the impacted grafts which have not yet remodeled, would be clinically relevant for the outcome of the operation, since these parts are at high stress during the whole remodeling period. Complete osseous remodeling may not be necessary to obtain a good clinical result with a morselized impacted graft.

U2 - 10.1080/000164701753606743

DO - 10.1080/000164701753606743

M3 - Article

VL - 72

SP - 78

EP - 82

JO - Acta Orthopaedica

JF - Acta Orthopaedica

SN - 1745-3682

IS - 1

ER -