Skip to main content
Top
Published in: Journal of Orthopaedic Surgery and Research 1/2020

01-12-2020 | Injectable Filler | Research article

Clinical outcome and explant histology after using a cellular bone allograft in two-stage total hip arthroplasty

Authors: Cambize Shahrdar, Julie McLean, Elena Gianulis, Davorka Softic, Xiaofei Qin, Mark A. Moore, Jingsong Chen

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2020

Login to get access

Abstract

Background

Although use of cellular bone allografts (CBA) in orthopedic surgery has become increasingly common, little information is available regarding their short-term clinical performance. In these two case reports of two-stage hip arthroplasties, ViviGen Formable CBA (V-CBA) was used in stage one to fill voids left by previous metal implants.

Methods

The two patients had distinctly different health profiles, but each of them had previous metal implants due to a hip fracture. In the otherwise healthy 49-year-old male patient, the total hip arthroplasty (THA) was performed 7 weeks after nail removal and V-CBA backfill. In the 64-year-old female patient with Type 1 diabetes and severe osteoporosis, stage 2 was performed after 12 weeks. At the time of THA for each patient, bone containing some V-CBA was removed to accommodate the hip implant. The explants were histologically analyzed for bone matrix, mineralization, and neovascularization.

Results

Histological staining showed substantial new bone formation and neovascularization in both explants albeit at different levels of maturity.

Conclusions

Although limited, these results suggest that V-CBA may facilitate new bone formation in healthy as well as in metabolically challenged patients.

Level of evidence

V, case report
Literature
1.
go back to reference Maradit Kremers H, Larson DR, Crowson CS, Kremers WK, Washington RE, Steiner CA, et al. Prevalence of total hip and knee replacement in the United States. J Bone Joint Surg Am. 2015;97(17):1386–97.CrossRef Maradit Kremers H, Larson DR, Crowson CS, Kremers WK, Washington RE, Steiner CA, et al. Prevalence of total hip and knee replacement in the United States. J Bone Joint Surg Am. 2015;97(17):1386–97.CrossRef
2.
go back to reference Srivastav S, Mittal V, Agarwal S. Total hip arthroplasty following failed fixation of proximal hip fractures. Indian J Orthop. 2008;42(3):279–86.CrossRef Srivastav S, Mittal V, Agarwal S. Total hip arthroplasty following failed fixation of proximal hip fractures. Indian J Orthop. 2008;42(3):279–86.CrossRef
3.
go back to reference Zhou S, Jung S, Hwang J. Mechanical analysis of femoral stress-riser fractures. Clin Biomech (Bristol, Avon). 2019;63:10–5.CrossRef Zhou S, Jung S, Hwang J. Mechanical analysis of femoral stress-riser fractures. Clin Biomech (Bristol, Avon). 2019;63:10–5.CrossRef
4.
go back to reference Khan WS, Rayan F, Dhinsa BS, Marsh D. An osteoconductive, osteoinductive, and osteogenic tissue-engineered product for trauma and orthopaedic surgery: how far are we? Stem Cells Int. 2012;2012:236231.PubMed Khan WS, Rayan F, Dhinsa BS, Marsh D. An osteoconductive, osteoinductive, and osteogenic tissue-engineered product for trauma and orthopaedic surgery: how far are we? Stem Cells Int. 2012;2012:236231.PubMed
5.
go back to reference Younger EM, Chapman MW. Morbidity at bone graft donor sites. J Orthop Trauma. 1989;3(3):192–5.CrossRef Younger EM, Chapman MW. Morbidity at bone graft donor sites. J Orthop Trauma. 1989;3(3):192–5.CrossRef
6.
go back to reference Masri BA, Mitchell PA, Duncan CP. Removal of solidly fixed implants during revision hip and knee arthroplasty. J Am Acad Orthop Surg. 2005;13(1):18–27.CrossRef Masri BA, Mitchell PA, Duncan CP. Removal of solidly fixed implants during revision hip and knee arthroplasty. J Am Acad Orthop Surg. 2005;13(1):18–27.CrossRef
7.
go back to reference Magnus MK, Iceman KL, Roukis TS. Living cryopreserved bone allograft as an adjunct for hindfoot arthrodesis. Clin Podiatr Med Surg. 2018;35(3):295–310.CrossRef Magnus MK, Iceman KL, Roukis TS. Living cryopreserved bone allograft as an adjunct for hindfoot arthrodesis. Clin Podiatr Med Surg. 2018;35(3):295–310.CrossRef
8.
go back to reference Roukis TS, Samsell B. A New approach to ankle and foot arthrodesis procedures using a living cellular bone matrix: a case series. Clin Res Foot Ankle. 2018;6(3). Roukis TS, Samsell B. A New approach to ankle and foot arthrodesis procedures using a living cellular bone matrix: a case series. Clin Res Foot Ankle. 2018;6(3).
9.
go back to reference Nilsdotter A, Bremander A. Measures of hip function and symptoms: Harris Hip Score (HHS), Hip Disability and Osteoarthritis Outcome Score (HOOS), Oxford Hip Score (OHS), Lequesne Index of Severity for Osteoarthritis of the Hip (LISOH), and American Academy of Orthopedic Surgeons (AAOS) Hip and Knee Questionnaire. Arthritis Care Res (Hoboken). 2011;63(Suppl 11):S200–7.CrossRef Nilsdotter A, Bremander A. Measures of hip function and symptoms: Harris Hip Score (HHS), Hip Disability and Osteoarthritis Outcome Score (HOOS), Oxford Hip Score (OHS), Lequesne Index of Severity for Osteoarthritis of the Hip (LISOH), and American Academy of Orthopedic Surgeons (AAOS) Hip and Knee Questionnaire. Arthritis Care Res (Hoboken). 2011;63(Suppl 11):S200–7.CrossRef
10.
go back to reference LifeNet Health. SOP: TM-40-014. H&E Staining of Histological Tissue Samples. 2017. LifeNet Health. SOP: TM-40-014. H&E Staining of Histological Tissue Samples. 2017.
11.
go back to reference Delmas PDaM, L. The proteins in bone. In: Mundy GR, editor. Physiology and Pharmacology of Bone. New York: Springer-Verlag; 1993. p. 673-724. Delmas PDaM, L. The proteins in bone. In: Mundy GR, editor. Physiology and Pharmacology of Bone. New York: Springer-Verlag; 1993. p. 673-724.
12.
go back to reference Jiao H, Xiao E, Graves DT. Diabetes and its effect on bone and fracture healing. Curr Osteoporos Rep. 2015;13(5):327–35.CrossRef Jiao H, Xiao E, Graves DT. Diabetes and its effect on bone and fracture healing. Curr Osteoporos Rep. 2015;13(5):327–35.CrossRef
13.
go back to reference Calori GM, Albisetti W, Agus A, Iori S, Tagliabue L. Risk factors contributing to fracture non-unions. Injury. 2007;38(Suppl 2):S11–8.CrossRef Calori GM, Albisetti W, Agus A, Iori S, Tagliabue L. Risk factors contributing to fracture non-unions. Injury. 2007;38(Suppl 2):S11–8.CrossRef
14.
go back to reference Pieske O, Wittmann A, Zaspel J, Loffler T, Rubenbauer B, Trentzsch H, et al. Autologous bone graft versus demineralized bone matrix in internal fixation of ununited long bones. J Trauma Manag Outcomes. 2009;3:11.CrossRef Pieske O, Wittmann A, Zaspel J, Loffler T, Rubenbauer B, Trentzsch H, et al. Autologous bone graft versus demineralized bone matrix in internal fixation of ununited long bones. J Trauma Manag Outcomes. 2009;3:11.CrossRef
15.
go back to reference Wright NC, Looker AC, Saag KG, Curtis JR, Delzell ES, Randall S, et al. The recent prevalence of osteoporosis and low bone mass in the United States based on bone mineral density at the femoral neck or lumbar spine. J Bone Miner Res. 2014;29(11):2520–6.CrossRef Wright NC, Looker AC, Saag KG, Curtis JR, Delzell ES, Randall S, et al. The recent prevalence of osteoporosis and low bone mass in the United States based on bone mineral density at the femoral neck or lumbar spine. J Bone Miner Res. 2014;29(11):2520–6.CrossRef
16.
go back to reference Harold N Rosen M. Drugs that affect bone metabolism 2019 Harold N Rosen M. Drugs that affect bone metabolism 2019
17.
go back to reference Surgical Site Infection (SSI) Event. Centers for Disease Control and Prevention; 2019. Surgical Site Infection (SSI) Event. Centers for Disease Control and Prevention; 2019.
18.
go back to reference Glance LG, Stone PW, Mukamel DB, Dick AW. Increases in mortality, length of stay, and cost associated with hospital-acquired infections in trauma patients. Arch Surg. 2011;146(7):794–801.CrossRef Glance LG, Stone PW, Mukamel DB, Dick AW. Increases in mortality, length of stay, and cost associated with hospital-acquired infections in trauma patients. Arch Surg. 2011;146(7):794–801.CrossRef
Metadata
Title
Clinical outcome and explant histology after using a cellular bone allograft in two-stage total hip arthroplasty
Authors
Cambize Shahrdar
Julie McLean
Elena Gianulis
Davorka Softic
Xiaofei Qin
Mark A. Moore
Jingsong Chen
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2020
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-020-1542-x

Other articles of this Issue 1/2020

Journal of Orthopaedic Surgery and Research 1/2020 Go to the issue