Abstract
In impaction allografting, the host bone interface consists of morsellized allograft alone or as a composite with bone cement. The objective of this study was to investigate the host bone temporal changes in the interface for these two materials in a rat bone chamber model. The composite-host bone interface strength was significantly higher at three weeks and was higher than the allograft construct. Limited allograft, but extensive periosteal remodelling, was observed at three weeks. At six weeks a new medullary canal was formed and the endosteal cortex was partially absorbed. Endosteal absorption resulting in medullary canal widening may be responsible for clinically unstable stems after impaction allografting.
The host bone interface after impaction allografting consists of morsellized allograft alone or as a composite with cement and it may be important for the clinical success of this procedure. The purpose of this study was to investigate the temporal changes of these interfaces in a rat bone chamber model.
Bone chambers were inserted in both tibiae of thirty-three rats and tightened to the endosteal surface to create a microenvironment. One chamber was filled with allograft bone and the other with an allograft/ cement composite. After zero, three, and six weeks, the rats were euthanized, the interfaces mechanically tested and processed for histomorphometric analysis.
The composite-host bone interface strength was significantly higher at three weeks and was higher than the allograft construct. Extensive periosteal remodelling was observed at three weeks. At six weeks a new medullary canal was formed and the endosteal cortex was partially absorbed.
The increased interface strength of the composite-host bone interface was due to fibrous tissue attachment rather than direct bonding of the bone particles. Cortical porosity and cancellisation is known to be caused by a damaged endosteal circulation resulting in medullary canal widening and may cause clinically unstable implants.
Interface strength of the composite-host bone interface was increased at three weeks through fibrous tissue attachment. A damaged endosteal circulation caused cortical porosis and cancellisation.
With this rat bone chamber model a potential cause of stem subsidence after impacting allografting was identified.
Funding: The George W. Bagby Research Fund.
The Canadian Institutse of Health Research.
The Maurice E. Müller Foundation.
The Swiss Academy of Engineering Science.
The Robert Mathys Foundation.
Correspondence should be addressed to Cynthia Vezina, Communications Manager, COA, 4150-360 Ste. Catherine St. West, Westmount, QC H3Z 2Y5, Canada
