Impaction Grafting and Cement in Acetabular Revision Arthroplasty

  • Tom J. J. H. Slooff
  • P. Buma
  • J. W. Schimmel
  • J. Gardeniers
  • R. Huiskes


Animal experiments were performed to restore bony defects with morsellized allograft chips. Acetabular defects were created in the Dutch milk goat and impacted with fresh frozen allograft bone chips. The speed of consolidation with the host bone bed, the mechanism and completeness of incorporation and the processes at the graft cement interface were studied in detail with histological and biomechanical procedures.

Histology showed that the graft had consolidated with the trabecular host bone bed within three weeks. In the subsequent period a front of vascular sprouts infiltrated the graft. Graft resorption, new bone formation and bone remodelling resulted in a new trabecular structure with optimal trabecular orientation for load bearing. After twelve weeks only scarce remnants of the original dead graft material remained in the incorporated area of the graft. At revascularized areas of the graft-cement interface, graft resorption and new bone formation had resulted in direct vital bone-cement contact sites and in areas with a soft tissue interface. After longer follow-up periods progressive interface formation and loosening of the cup was found in most of the animals.

The histological results were confirmed by biomechanical stability tests. In the first postoperative weeks the stability of the reconstruction increased, but at later follow-up periods, interface formation at the new bone-cement layer compromised the stability of the reconstruction.

The results indicated that reconstruction with morsellized graft material leads to rapid consolidation, incorporation and remodelling of the graft. Problems at the graft-cement interface are probably not related to the use of the morsellized graft, but to the goat model used.


Bone Graft Cement Layer Bone Transplantation Impaction Grafting Graft Incorporation 
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Copyright information

© Springer-Verlag/Wien 1996

Authors and Affiliations

  • Tom J. J. H. Slooff
    • 1
  • P. Buma
    • 2
  • J. W. Schimmel
    • 1
  • J. Gardeniers
    • 1
  • R. Huiskes
    • 2
  1. 1.Institute of OrthopaedicsUniversity Hospital NijmegenNijmegenThe Netherlands
  2. 2.Institute of Orthopaedics, Laboratory of Experimental OrthopaedicsUniversity Hospital NijmegenNijmegenThe Netherlands

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