THE USE OF AUTOLOGOUS GROWTH FACTORS IN JOINT REPLACEMENT ARTHROPLASTY

Abstract

The mean way to fill bone loss, to fix loss of continuity or to correct severe dysplasia in pelvis and in the femur during replacement or revision arthroplasty is the augmentation of the bone stock by mean of bulky or morcellized bone allograft. In order to treat these problems, limiting the possible complications connected to the use of massive bone allograft (bulky or morcellized), and to simplify the surgical procedure we thought to apply in selected cases the platelet’s derived autologous growth factors (AGF), alone or added to Granular Hydroxyapatite.

From january 2001 to june 2003 we have applied-autologous growth factors in 10 cases. The diagnosis was: 5 acetabula in primary THR, 2 acetabular and 1 femoral revision after THR, 1 femoral and 1tibial revision after TKR. We applied the pure AGF in 2 cases and AGF plus Granular Hydroxyapatite in 8 cases. We used emispherical, HA coated, uncemented acetabular cup plus screws (6 cases), uncemented revision cup plus screws (1 case), straight HA coated uncemented femoral stem (1 cases), semi-constrained cemented TKR prosthesis (1 cases). The mean age atoperation was 45 years (21–69). The mean follow-up time was 12,5 months (28–6).

At the last follow up in all the implants there were no signs of loosening; all the graft seems to be well osteo integrated except in 1 case in which we have had fracture and partial reabsorption of the granular HA, without failure of the implant. We haven’t had any inflammatory reaction or signs of intollerance to the graft.

The short term results of our experience seems to be encouraging. If these results will be confirmed in the future the application of AGF should reduce the utilization of massive bone allograft.