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Limb Salvage pp 335-343 | Cite as

Comparison of Autogenous Cortical Graft and Demineralized Allogenic Bone Matrix (DABM) in the Fixation of Segmental Prosthesis

  • B. W. Wippermann
  • R. W. W. Hsu
  • E. Y. S. Chao
  • F. H. Sim
Conference paper

Abstract

Numerous options are available today to reconstruct large bony defects after tumor resection, failed total joint arthroplasty, or trauma. Custom-designed segmental bone and joint implants [2] are being used widely, but the conventional prosthetic fixation method may lead to stem loosening or fracture after prolonged in vivo utilization. Since these late complications are mainly attributed to failure of the bone cement [3], biological fixation. using porous implants has been advocated. Porous coating applied to the stems to achieve biological fixation of segmental prostheses has several disadvantages which may predispose the implants to stem fracture or cause bone resorption. A new concept of prosthetic fixation through extracortical bone bridging and growth over the porous-coated segmental portion of the implant has been introduced [4–6]. Morselized corticocancellous autogenous bone grafts are applied over the porous-coated segment and adjacent to cortex to induce bone formation. The stems of these implants are solid and are cemented to achieve initial implant stability.

Keywords

Bone Cement Demineralized Bone Matrix Triceps Muscle Torsional Strength Induce Bone Formation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Bolander ME, Balian G (1986) The use of demineralized bone matrix in the repair of segmental defects. Augmentation with extracted matrix proteins and a comparison with autologous grafts. J Bone Joint Surg [Am] 68: 1264–1274Google Scholar
  2. 2.
    Bradish CF, Kemp HBS, Scales JT, Wilson JN (1987) Distal femoral replacement by custom made prosthesis: clinical foJlow-up and survivorship analysis. J Bone Joint Surg [Br] 69: 276–284Google Scholar
  3. 3.
    Chao EY, Coventry MB (1981) Fracture of the femoral component after total hip replacement. J Bone Joint Surg [Am] 63: 1078–1094Google Scholar
  4. 4.
    Chao EY, Sim FH (1985) Modular prosthetic system for segmental bone and joint replacement after tumor resection. Orthopedics 8: 641–651PubMedGoogle Scholar
  5. 5.
    Chao EY, Okada Y, Hein T, Sim FH, Pritchard DJ, Shives TC (1987) Extracortical bone bridging: a new concept for implant fixation. Transactions of the 33rd ORS 12: 435Google Scholar
  6. 6.
    Chao EYS (1989) A composite fixation principle for modular segmental defect replacement (SDR) prostheses. Orthop Clin North Am: 20(3): 439–453PubMedGoogle Scholar
  7. 7.
    Heck DA, Chao EYS, Sim FH, Pritchard DJ, Shives TC (1986) Titanium fibermetal segmental replacement prostheses. Clin Orthop 204: 266–285PubMedGoogle Scholar
  8. 8.
    Heck DA, Nakajima I, Kelly PJ, Chao EY (1986) The effect ofload alteration on the biological and biomechanical performance of a titanium fibermetal segmental prosthesis. J Bone Joint Surg [Am] 68: 118–126Google Scholar
  9. 9.
    Kohler P, Kreichbergs A (1987) Incorporation of autoclaved antogeneic bone supplemented with allogenic demineralized bone matrix. An experimental study in the rabbit. Clin Orthop 218: 247–258PubMedGoogle Scholar
  10. 10.
    Kuo KN, Gitelis S, Sim FH, Pritchard D, Chao E, Rostoker W, Galante JO, McDonald P (1983) Segmental replacement of long bones using titanium fiber metal composite following tumor resection. Clin Orthop 176: 108–114PubMedGoogle Scholar
  11. 11.
    Lindholm TS, Urist MR (1980) A quantitative analysis of new bone formation by induction in compositive grafts of bone marrow and bone matrix. Clin Orthop 150: 288–300PubMedGoogle Scholar
  12. 12.
    Nilsson OS, Urist MR, Dawson EG, Schmalzried TP, Finerman GA (1986) Bone repair induced by bone morphogenetic protein in ulnar defects in dogs. J Bone Joint Surg [Br] 68: 4: 635–642Google Scholar
  13. 13.
    Okada Y, Suka T, Sim FR, Gorski JP, Chao EYS (1988) Comparison of replacement prostheses for segmental defects of bone. Different porous coatings for extracortical fixation. J Bone Joint Surg [Am] 70(2): 160–172Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1991

Authors and Affiliations

  • B. W. Wippermann
    • 1
  • R. W. W. Hsu
    • 1
  • E. Y. S. Chao
    • 1
  • F. H. Sim
    • 1
  1. 1.Biomechanics Laboratory, Department of OrthopaedicsMayo Clinic/Mayo FoundationRochesterUSA

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