Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
811201 | Journal of the Mechanical Behavior of Biomedical Materials | 2012 | 9 Pages |
Impaction bone grafting using morcellised allograft can successfully restore bone stock in revision surgery. However, concerns exist regarding supply of bone and transmission of infection. Bone-graft extenders, such as tricalcium phosphate (TCP) and hydroxyapatite (HA), are used to minimise the use of donor bone. However, concerns exist around a reported increased risk of femoral fracture during impaction bone grafting with a 1:1 mixture of TCP/HA and morcellised bone graft (MBG) during impaction grafting in human cadaveric femora. Using a sawbones model, it was evaluated whether there was increased femoral cortical strain with a HA:MBG mixture during impaction grafting compared to MBG impacted at the same and a greater force. Subsequently the subsidence behaviour of the different graft mixes was compared by using a loaded femoral stem in an endurance test. It was demonstrated that the femora with the MBG:HA graft had greater cortical hoop stresses but improved subsidence behaviour compared to a graft composed of pure MBG impacted at the same force.
► We examined the effect of impaction force and addition of hydroxyapatite in a hip model. ► Greater force decreases subsidence of a femoral hip stem but increases hoop strain. ► Addition of hydroxyapatite to bone graft decreases femoral implant subsidence. ► Addition of hydroxyapatite to bone graft increases hoop strain during impaction. ► Adding hydroxyapatite to bone graft might be better than increased impaction force.