PubMed · 9801229
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N F Friederich. 1998. Duplicate publication?. https://pubmed.ncbi.nlm.nih.gov/9801229/
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Morsellized and compacted femoral heads salvaged after hip arthroplasty constitute an excellent bone replacement material. Access to this material has substantially improved prognosis following replacement of loosened prostheses, a finding contrary to previous experience with uncompacted bone grafts and for which only hypothetical explanations are available. Although bank bone is a material without manifest value beyond its material properties, it is sometimes referred to as a transplant, a usage that has resulted in its occasional use under the misapprehension that it will promote bone repair, which may cause problems. Otherwise, bank bone is more or less innocuous and is not associated with a greater risk of viral infection transmission than is blood transfusion. The article provides a review of the biological effects to be expected of bank bone implants, how the risk of infection can be avoided, and which indications are appropriate.
Handling morcellized bone-graft during impaction grafting can be a slow and laborious procedure. An alternative quick technique is described.
A matched comparison was made between total hip arthroplasties done for osteonecrosis and those done for osteoarthritis. Patients were matched for age, sex, surgical approach, prosthesis, and surgeon. All received cemented Charnley replacements and had minimal follow-up of 10 years. There were 118 women and 70 men with a mean age of 58 years. Thirty-five patients were younger than 50. The mean follow-up was 17.8 years (range, 10 to 25.4 years). Revision rates for osteonecrosis and osteoarthritis were 18% and 19% (not significant). The mechanical failure rate (revision for loosening plus radiographic loosening) was greater, but not significantly so, in the osteonecrosis group. In patients younger than 50 years, the revision rate in osteonecrosis (50%) was significantly higher than that in any other group. Similarly, the mechanical failure rate in osteonecrosis was significantly greater in the patients younger than 50. Radiographic femoral loosening was greater in osteonecrosis at all follow-up intervals, and dislocations occurred more frequently in the osteonecrosis group than in the osteoarthritis group. Results of arthroplasty in both groups were comparable in patients over 50 years of age, although patients with osteonecrosis had an increased rate of dislocation. Patients with osteonecrosis who are younger than 50 years have a significantly higher rate of mechanical failure than those with osteoarthritis who are younger than 50 years. Cemented total hip arthroplasty should be recommended in this group with caution if at all.