A novel, multi-level approach to assess allograft incorporation in revision total hip arthroplasty.
Acetabulum
/ diagnostic imaging
Aged
Aged, 80 and over
Algorithms
Allografts
/ diagnostic imaging
Arthroplasty, Replacement, Hip
/ methods
Female
Femur
/ diagnostic imaging
Humans
Male
Middle Aged
Models, Theoretical
Radiographic Image Interpretation, Computer-Assisted
/ methods
Plastic Surgery Procedures
Reoperation
Transplantation, Homologous
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
16 09 2020
16 09 2020
Historique:
received:
05
06
2020
accepted:
20
08
2020
entrez:
17
9
2020
pubmed:
18
9
2020
medline:
15
12
2020
Statut:
epublish
Résumé
The successful use of allografts in reconstructive orthopedic surgery, including revision total hip arthroplasty (THA), has been outlined repeatedly. Nonetheless, as previous studies were primarily based on clinical follow-ups, we aimed to create an algorithm that accurately determines the extent of allograft incorporation in the acetabulum and femur using a suite of high-resolution imaging techniques. This study is based on a large patient database including > 4,500 patient data with previous revision THA and simultaneous use of allografts. While the database was continuously matched with the deceased individuals at the local forensic medicine department, complete hips were retrieved in case of a positive match. A positive match was achieved for n = 46 hips at a mean follow-up of 11.8 ± 5.1 years. Comprehensive imaging included contact radiography, high-resolution computed tomography (HR-pQCT), undecalcified histology of ground sections and quantitative backscattered electron imaging (qBEI). We here define a histomorphometric toolkit of parameters to precisely characterize the incorporation of structural (bulk) and morselized (chip) allografts in the acetabulum (n = 38) and femur (n = 8), including the defect area and interface length, microstructural and cellular bone turnover parameters as well as overlap and fibrosis thickness. This collection of samples, through its unique study design and precise definition of incorporation parameters, will provide the scientific community with a valuable source for further in-depth investigation of allograft incorporation and, beyond that, the regenerative potential of this osteoconductive scaffold.
Identifiants
pubmed: 32939007
doi: 10.1038/s41598-020-72257-3
pii: 10.1038/s41598-020-72257-3
pmc: PMC7494851
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
15226Références
Pivec, R., Johnson, A. J., Mears, S. C. & Mont, M. A. Hip arthroplasty. Lancet 380, 1768–1777 (2012).
doi: 10.1016/S0140-6736(12)60607-2
Endoprothesenregister Deutschland (EPRD). Jahresbericht 2019. https://www.eprd.de/fileadmin/user_upload/Jahresbericht_2019_doppelseite_2.0.pdf (2019).
IQTIG—Institut für Qualitätssicherung und Transparenz im Gesundheitswesen: Qualitätsreport 2019. https://iqtig.org/downloads/berichte/2018/IQTIG_Qualitaetsreport-2019_2019-09-25.pdf (2019).
Bozic, K. J. et al. The epidemiology of revision total hip arthroplasty in the United States. J. Bone Joint Surg. Am. 91, 128–133 (2009).
doi: 10.2106/JBJS.H.00155
Deirmengian, G. K., Zmistowski, B., O’Neil, J. T. & Hozack, W. J. Management of acetabular bone loss in revision total hip arthroplasty. J. Bone Joint Surg. Am. 93, 1842–1852 (2011).
doi: 10.2106/JBJS.J.01197
Leopold, S. S., Jacobs, J. J. & Rosenberg, A. G. Cancellous allograft in revision total hip arthroplasty. A clinical review. Clin. Orthop. Relat. Res. 86–97 (2000).
Knight, J. L., Fujii, K., Atwater, R. & Grothaus, L. Bone-grafting for acetabular deficiency during primary and revision total hip arthroplasty. A radiographic and clinical analysis. J. Arthroplasty 8, 371–382 (1993).
Ullmark, G. & Obrant, K. J. Histology of impacted bone-graft incorporation. J. Arthroplasty 17, 150–157 (2002).
doi: 10.1054/arth.2002.29393
Schreurs, B. W. et al. Acetabular revision with impacted morsellised cancellous bone grafting and a cemented acetabular component: a 20- to 25-year follow-up. J. Bone Joint Surg. Br. 91, 1148–1153 (2009).
doi: 10.1302/0301-620X.91B9.21750
Dua, A., Kiran, K., Malhotra, R. & Bhan, S. Acetabular reconstruction using fresh frozen bone allograft. Hip Int. 20, 143–149 (2010).
doi: 10.1177/112070001002000203
Deakin, D. E. & Bannister, G. C. Graft incorporation after acetabular and femoral impaction grafting with washed irradiated allograft and autologous marrow. J. Arthroplasty 22, 89–94 (2007).
doi: 10.1016/j.arth.2006.02.162
Schreurs, B. W. et al. Acetabular revision with impacted morselized cancellous bone graft and a cemented cup in patients with rheumatoid arthritis: three to fourteen-year follow-up. J. Bone Joint Surg. Am. 85, 647–652 (2003).
doi: 10.2106/00004623-200304000-00010
Ullmark, G., Sorensen, J. & Nilsson, O. Bone healing of severe acetabular defects after revision arthroplasty. Acta Orthop. 80, 179–183 (2009).
doi: 10.3109/17453670902947416
Ullmark, G., Hallin, G. & Nilsson, O. Impacted corticocancellous allografts and cement for femoral revision of total hip arthroplasty using Lubinus and Charnley prostheses. J. Arthroplasty 17, 325–334 (2002).
doi: 10.1054/arth.2002.30782
Rolvien, T., Barbeck, M., Wenisch, S., Amling, M. & Krause, M. Cellular mechanisms responsible for success and failure of bone substitute materials. Int. J. Mol. Sci. 19, 2893 (2018).
doi: 10.3390/ijms19102893
Butscheidt, S. et al. Incorporation and remodeling of structural allografts in acetabular reconstruction: Multiscale, micro-morphological analysis of 13 pelvic explants. J. Bone Joint Surg. Am. 100, 1406–1415 (2018).
doi: 10.2106/JBJS.17.01636
Paprosky, W. G., Perona, P. G. & Lawrence, J. M. Acetabular defect classification and surgical reconstruction in revision arthroplasty. A 6-year follow-up evaluation. J. Arthroplasty 9, 33–44 (1994).
Telleria, J. J. & Gee, A. O. Classifications in brief: Paprosky classification of acetabular bone loss. Clin. Orthop. Relat. Res. 471, 3725–3730 (2013).
doi: 10.1007/s11999-013-3264-4
Slooff, T. J. et al. Acetabular and femoral reconstruction with impacted graft and cement. Clin. Orthop. Relat. Res. 324, 108–115 (1996).
doi: 10.1097/00003086-199603000-00013
Friesecke, C., Granes, R. & Siemssen, N. Bone transplantation with total hip endoprosthesis for diffuse pigmented villonodular synovitis. Orthopade 42, 884–888 (2013).
doi: 10.1007/s00132-013-2170-5
Englbrecht, E. & Heinert, K. in Primär- und Revisions- Alloarthroplastik Hüft- und Kniegelenk 189–201 (Springer, 1987).
Ibrahim, D. A. & Fernando, N. D. Classifications in brief: The Paprosky classification of femoral bone loss. Clin. Orthop. Relat. Res. 475, 917–921 (2017).
doi: 10.1007/s11999-016-5012-z
Valle, C. J. & Paprosky, W. G. Classification and an algorithmic approach to the reconstruction of femoral deficiency in revision total hip arthroplasty. J. Bone Joint Surg. Am. 85-A Suppl 4, 1–6 (2003).
Gie, G. A. et al. Impacted cancellous allografts and cement for revision total hip arthroplasty. J. Bone Joint Surg. Br. 75, 14–21 (1993).
doi: 10.1302/0301-620X.75B1.8421012
Donath, K. The diagnostic value of the new method for the study of undecalcified bones and teeth with attached soft tissue (Sage-Schliff (sawing and grinding) technique). Pathol. Res. Pract. 179, 631–633 (1985).
doi: 10.1016/S0344-0338(85)80209-0
Hahn, M., Vogel, M. & Delling, G. Undecalcified preparation of bone tissue: Report of technical experience and development of new methods. Virchows Arch. A Pathol. Anat. Histopathol. 418, 1–7 (1991).
doi: 10.1007/BF01600238
Koehne, T. et al. Trends in trabecular architecture and bone mineral density distribution in 152 individuals aged 30–90 years. Bone 66, 31–38 (2014).
doi: 10.1016/j.bone.2014.05.010
Kubek, D. J., Gattone, V. H. 2nd. & Allen, M. R. Methodological assessment of acid-etching for visualizing the osteocyte lacunar-canalicular networks using scanning electron microscopy. Microsc. Res. Tech. 73, 182–186 (2010).
pubmed: 19725069
Milovanovic, P. et al. Osteocytic canalicular networks: morphological implications for altered mechanosensitivity. ACS Nano 7, 7542–7551 (2013).
doi: 10.1021/nn401360u
Garbuz, D., Morsi, E. & Gross, A. E. Revision of the acetabular component of a total hip arthroplasty with a massive structural allograft. Study with a minimum five-year follow-up. J. Bone Joint Surg. Am. 78, 693–697 (1996).
Prieto, H. A. et al. Structural allograft supporting a trabecular metal cup provides durable results in complex revision arthroplasty. J. Arthroplasty 32, 3488–3494 (2017).
doi: 10.1016/j.arth.2017.05.051
Stigbrand, H., Gustafsson, O. & Ullmark, G. A 2- to 16-year clinical follow-up of revision total hip arthroplasty using a new acetabular implant combined with impacted bone allografts and a cemented cup. J. Arthroplasty 33, 815–822 (2018).
doi: 10.1016/j.arth.2017.10.006
Winter, E. et al. Allogeneic cancellous bone graft and a Burch-Schneider ring for acetabular reconstruction in revision hip arthroplasty. J. Bone Joint Surg. Am. 83, 862–867 (2001).
doi: 10.2106/00004623-200106000-00007
Halliday, B. R., English, H. W., Timperley, A. J., Gie, G. A. & Ling, R. S. Femoral impaction grafting with cement in revision total hip replacement. Evolution of the technique and results. J. Bone Joint Surg. Br. 85, 809–817 (2003).
Rogers, B. A. et al. Proximal femoral allograft in revision hip surgery with severe femoral bone loss: a systematic review and meta-analysis. J. Arthroplasty 27, 829–836 e821 (2012).
Lee, S. H., Ahn, Y. J., Chung, S. J., Kim, B. K. & Hwang, J. H. The use of allograft prosthesis composite for extensive proximal femoral bone deficiencies: a 2-to 9.8-year follow-up study. J. Arthroplasty 24, 1241–1248 (2009).
Hooten, J. P., Jr., Engh, C. A., Heekin, R. D. & Vinh, T. N. Structural bulk allografts in acetabular reconstruction. Analysis of two grafts retrieved at post-mortem. J. Bone Joint Surg. Br. 78, 270–275 (1996).
van der Donk, S., Buma, P., Slooff, T. J., Gardeniers, J. W. & Schreurs, B. W. Incorporation of morselized bone grafts: A study of 24 acetabular biopsy specimens. Clin. Orthop. Relat. Res. 131–141 (2002).
Buma, P. et al. Impacted graft incorporation after cemented acetabular revision. Histological evaluation in 8 patients. Acta Orthop. Scand. 67, 536–540 (1996).
Ling, R. S., Timperley, A. J. & Linder, L. Histology of cancellous impaction grafting in the femur. A case report. J. Bone Joint Surg. Br. 75, 693–696 (1993).
van der Donk, S., Buma, P., Verdonschot, N. & Schreurs, B. W. Effect of load on the early incorporation of impacted morsellized allografts. Biomaterials 23, 297–303 (2002).
Rolvien, T. et al. Long-term immobilization in elderly females causes a specific pattern of cortical bone and osteocyte deterioration different from postmenopausal osteoporosis. J. Bone Miner. Res. 35, 1343–1351 (2020).
doi: 10.1002/jbmr.3970
Malinin, T. I., Carpenter, E. M. & Temple, H. T. Particulate bone allograft incorporation in regeneration of osseous defects; importance of particle sizes. Open Orthop. J. 1, 19–24 (2007).
doi: 10.2174/1874325000701010019
Schimmel, J. W., Buma, P., Versleyen, D., Huiskes, R. & Slooff, T. J. Acetabular reconstruction with impacted morselized cancellous allografts in cemented hip arthroplasty: A histological and biomechanical study on the goat. J. Arthroplasty 13, 438–448 (1998).
doi: 10.1016/S0883-5403(98)90010-9
Shinar, A. A. & Harris, W. H. Bulk structural autogenous grafts and allografts for reconstruction of the acetabulum in total hip arthroplasty. Sixteen-year-average follow-up. J. Bone Joint Surg. Am. 79, 159–168 (1997).
Makita, H. et al. Revision total hip arthroplasty using the Kerboull acetabular reinforcement device and structural allograft for severe defects of the acetabulum. J. Arthroplasty 32, 3502–3509 (2017).
doi: 10.1016/j.arth.2017.06.029