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Bone regeneration 6 years after impaction bone grafting: a PET analysis
Gösta Ullmark1, Jens Sörensen, Bengt Långström
1Department of Orthopedics, Länssjukhuset, SE-801 87, Gävle, Sweden.
Acta Orthopaedica
|April 28, 2007
Summary
Impacted morselized bone allograft in hip revision surgery shows normalized bone metabolism and good long-term implant fixation, indicating successful bone regeneration within the graft.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Radiology
Background:
- Impacted morselized bone allograft is widely used in revision total hip arthroplasty for prosthetic loosening.
- While clinical outcomes are generally good, the bone regeneration process within the allograft remains poorly understood.
Purpose of the Study:
- To quantitatively assess bone regeneration and metabolism in impacted morselized bone allograft used in revision total hip arthroplasty.
- To evaluate the long-term prognosis of implant fixation by analyzing bone metabolism at 6 years post-surgery.
Main Methods:
- Five patients undergoing revision total hip arthroplasty with impacted morselized frozen allograft and cemented stems were studied.
- Positron emission tomography ([18F]-fluoride PET) was employed to image and quantify new bone formation around the femoral stem at 6 years post-surgery.
Main Results:
- Bone formation initially progressed through the graft to the cement layer within the first year.
- At 6 years, bone metabolism in the allograft had significantly reduced and normalized compared to the first year and the contralateral healthy femur.
- Slightly increased metabolism persisted distally to the stem tip, with minor patchy areas suggesting fibrous healing.
Conclusions:
- The normalized bone metabolism indicates complete regeneration of the allografted bone.
- This suggests a favorable long-term prognosis for the fixation of implants in revision total hip arthroplasty.
