Comparative Study of the Osteointegration of Irradiated and Non-irradiated Bone Grafts Used in Patients with Revision Hip Arthroplasty^[*]

Abstract

Objective To evaluate and compare the osteointegration of irradiated and non-irradiated frozen bone grafts used in 21 patients undergoing revision hip arthroplasty procedures with the Exeter technique.

Methods A retrospective study of 21 patients undergoing revision hip arthroplasty with the Exeter technique using bone tissues treated or not with gamma radiation between 2013 and 2014. The patients were divided into two groups according to the use of grafts treated or not with ionizing radiation (gamma rays); as such, these groups were classified as irradiated or non-irradiated. The osteointegration results determined by radiographic analysis of these grafts were compared in the postoperative period of 6 and 12 months.

Results Comparing the graft osteointegration in all patients at 6 and 12 months postoperatively, we noticed a significant difference in the radiographic evaluations in this period (p = 0.031). Out of the patients studied, 7 were from the irradiated group, and 14 belonged to the non-irradiated group. No statistically significant differences were observed (p = 0.804) regarding osteointegration when we compared the irradiated and non-irradiated groups.

Conclusion There was no significant difference in the use of irradiated or non-irradiated grafts in revision hip arthroplasty procedures with the Exeter technique.

Keywords

osteointegration - tissue bank - bone grafts - arthroplasty

^* Work developed at Hospital Central da Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil.

• Referências

• 1 Associação Brasileira de Transplantes de Órgãos (ABTO). Registro Brasileiro de Transplantes. Ano XXII n. 4, jan/fev 2016. Disponível em: http://www.abto.org.br/abtov03/default.aspx?mn=457&c=900&s=0
• 2 Halliday BR, English HW, Timperley AJ, Gie GA, Ling RS. Femoral impaction grafting with cement in revision total hip replacement. Evolution of the technique and results. J Bone Joint Surg Br 2003; 85 (06) 809-817
• 3 Zabeu JL, Mercadante MT. Substitutos ósseos comparados ao enxerto ósseo autólogo em cirurgia ortopédica. Revisão sistemática da literatura. Rev Bras Ortop 2008; 43 (03) 59-68
• 4 Antebi U, Mathor MB, Silva AF, Guimarães RP, Honda EK. Efeitos da radiação ionizante nas proteínas presentes em ossos humanos desmineralizados, liofilizados ou congelados. Rev Bras Ortop 2016; 51 (02) 224-230
• 5 Sutherland CJ, Wilde AH, Borden LS, Marks KE. A ten-year follow-up of one hundred consecutive Müller curved-stem total hip-replacement arthroplasties. J Bone Joint Surg Am 1982; 64 (07) 970-982
• 6 Friedlaender GE, Goldberg VM. Bone and cartilage allografts: biology and clinical applications. Illinois: American Academy of Orthopedic Surgeons; 1991
• 7 Graham NM, Stockley I. The use of structural proximal femoral allografts in complex revision hip arthroplasty. J Bone Joint Surg Br 2004; 86 (03) 337-343
• 8 Dziedzic-Goclawska A. The application of ionising radiation to sterilise connective tissue allografts. In: Phillips GO. Radiation and tissue banking. World Scientific; Singapore: 2000: 57-99
• 9 Vastel L, Masse C, Crozier E. , et al. Effects of gamma irradiation on mechanical properties of defatted trabecular bone allografts assessed by speed-of-sound measurement. Cell Tissue Bank 2007; 8 (03) 205-210
• 10 Nguyen H, Morgan DA, Forwood MR. Sterilization of allograft bone: effects of gamma irradiation on allograft biology and biomechanics. Cell Tissue Bank 2007; 8 (02) 93-105
• 11 Pekkarinen T, Hietalal O, Jämsä T, Jalovaara P. Gamma irradiation and ethylene oxide in the sterilization of native reindeer bone morphogenetic protein extract. Scand J Surg 2005; 94 (01) 67-70
• 12 Conn RA, Peterson LF, Stauffer RN, Listrup D. Management of acetabular deficiency: long term results of bone grafting the acetabulum in total hip arthroplasty. Trans Orthop Res Soc 1985; 9: 451-452
• 13 Azuma T, Yasuda H, Okagaki K, Sakai K. Compressed allograft chips for acetabular reconstruction in revision hip arthroplasty. J Bone Joint Surg Br 1994; 76 (05) 740-744
• 14 Wilson MJ, Hook S, Whitehouse SL, Timperley AJ, Gie GA. Femoral impaction bone grafting in revision hip arthroplasty: 705 cases from the originating centre. Bone Joint J 2016; 98-B (12) 1611-1619
• 15 Jasty M, Harris WH. Salvage total hip reconstruction in patients with major acetabular bone deficiency using structural femoral head allografts. J Bone Joint Surg Br 1990; 72 (01) 63-67
• 16 Galia CR, Moreira LF. The Biology of Bone Grafts: Recent Advances in Arthroplasty, 2012. Samo K. Fokter, IntechOpen, InTech; 235-254 . DOI: 10.5772/27381.
• 17 Schreurs BW, Slooff TJ, Gardeniers JW, Buma P. Acetabular reconstruction with bone impaction grafting and a cemented cup: 20 years' experience. Clin Orthop Relat Res 2001; (393) 202-215
• 18 Böhm P, Bischel O. The use of tapered stems for femoral revision surgery. Clin Orthop Relat Res 2004; (420) 148-159
• 19 Phillips GO. Module 5: Processing. In: Multimedia distance learning package on tissue banking. Singapura: IAEA; 1997
• 20 Devito FS, Aristides RS, Honda EK, Chueire AG. O uso de enxerto homólogo na revisão de artroplastias do quadril com cimentação do componente acetabular. Acta Ortop Bras 2006; 14 (05) 280-282
• 21 Emms NW, Buckley SC, Stockley I, Hamer AJ, Kerry RM. Mid- to long-term results of irradiated allograft in acetabular reconstruction: a follow-up report. J Bone Joint Surg Br 2009; 91 (11) 1419-1423