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Massive osteoarticular knee allografts: structural changes evaluated with CT

K T Mattila1, J T Heikkila, A J Aho

  • 1Department of Diagnostic Radiology, University of Turku, Finland.

Radiology
|September 1, 1995
PubMed
Summary
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Computed tomography (CT) effectively tracks structural changes in massive osteoarticular knee allografts. Poor graft remodeling precedes insufficiency fractures, indicating CT

Area of Science:

  • Orthopedic surgery
  • Radiology
  • Biomedical engineering

Background:

  • Massive osteoarticular allografts are used in knee reconstruction.
  • Allograft incorporation involves complex structural changes.
  • Insufficiency fractures can occur in allografts, impacting outcomes.

Purpose of the Study:

  • To analyze structural changes in massive osteoarticular knee allografts using computed tomography (CT).
  • To identify CT findings that precede insufficiency (fatigue) fractures in these allografts.

Main Methods:

  • Retrospective evaluation of 12 massive osteoarticular knee allografts.
  • Repeat transaxial computed tomography (CT) scans were analyzed.
  • Mean follow-up duration was 53 months.

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Main Results:

  • Early cortical graft resorption was followed by thickening after 6 months.
  • Resorptive cysts and cortical irregularity developed, stabilizing after 2 years.
  • Late remodeling showed a subcortical sclerotic rim ('neocortex').
  • Four insufficiency fractures occurred postoperatively, preceded by poor remodeling.
  • Cancellous graft bone attenuation initially higher than host bone normalized within 3 years.

Conclusions:

  • CT effectively visualizes structural changes during allograft incorporation.
  • CT is superior to plain radiography for detecting insufficiency fractures.
  • CT follow-up provides crucial information on graft readiness for weight-bearing.