Advertisement

Repair of Massive Allografts: Histological, Nuclear Medicine and CT-Studies

  • Allan J. Aho
  • T. Ekfors
  • J. Knuuti
  • K. Mattila
  • J. Heikkilä

Summary

The repair of massive osteoarticular allografts was evaluated by invasive and non-invasive techniques utilizing histological biopsies, isotopes, particularly the SPECT method, and computed tomography (CT) techniques.

With regard to osteogenesis four different morphological anatomic areas were found. New bone formation began first at the host-graft junction induced by the host’s periosteum and the autogenous bone grafts. In the cortex postresorptional osteogenesis occurred as a thin appositional layer of lamellar bone. In the subchondral bone cyst-like small cavities resulting from resorption of Haversian canals revealed new lamellar bone of varying degree lining the cavity walls. However, large areas of the grafts remained necrotic and the new bone formation event (creeping substitution) was a long drawn-out process lasting years. The proportion of new bone formation averaged 36% (range 5–75%). Bone scans and SPECT (Single Photon Emission Computed Tomography) studies with 99mTcDPD indicated slight activity only at the outer layer of the cortex corresponding to histological observations. Computed tomography (CT) studies revealed first thinning and irregular defects of the cortex and small subcortical cysts. Later these resorptive changes repaired by gradual thickening of the cortex. On CT a neocortex, a circumferential bony structure inside the normal cortex was found to develop over several years.

Keywords

Single Photon Emission Compute Tomography Lamellar Bone Autogenous Bone Graft Haversian Canal Osteoarticular Allograft 
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.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Aho AJ, Penttinen R, Niinikoski J, Aho HJ (1992) Incorporation of massive half-joint allografts in dogs. In: Lindholm ST (ed) New trends in bone grafting. Tampere, Finland: University of Tampere, pp 176 – 185Google Scholar
  2. 2.
    Aho A J, Ekfors T, Dean PB, Aro HT, Ahonen A, Nikkanen V (1994) Incorporation and clinical results of large allografts of the extremities and pelvis. Clin Orthop 307: 200 – 213PubMedGoogle Scholar
  3. 3.
    Burchardt H (1987) Biology of bone transplantation. Orthop Clinics North Am 18: 187 – 196Google Scholar
  4. 4.
    Chase SN, Herndon CH (1955) The fate of autogenous and homogenous bone grafts: A historical review. J Bone Joint Surg 37-A: 809PubMedGoogle Scholar
  5. 5.
    Delloye C (1990) The bridging capacity of a cortical bone defect by different bone grafting materials and diaphyseal distraction lengthening. An experimental study. Thesis. LouvainGoogle Scholar
  6. 6.
    Enneking WF, Mindell ER (1991) Observations on massive retrieved human allografts. J Bone Joint Surg 73-A: 1123 – 1142PubMedGoogle Scholar
  7. 7.
    Friedlaender GE (1982) Current concepts review: Bone banking. J Bone Joint Surg 64-A: 307PubMedGoogle Scholar
  8. 8.
    Goldberg VM, Stevenson S (1987) Natural history of autografts and allografts. Clin Orthop Rel Res 225: 7 – 16Google Scholar
  9. 9.
    Mattila KT, Heikkila JT, Aho AJ, Manner I, Dean PB (1995) Structural changes in large human osteoarticular knee allografts studied with CT. Radiology 196: 657 – 660PubMedGoogle Scholar

Copyright information

© Springer-Verlag/Wien 1996

Authors and Affiliations

  • Allan J. Aho
    • 1
  • T. Ekfors
    • 2
  • J. Knuuti
    • 3
  • K. Mattila
    • 4
  • J. Heikkilä
    • 1
  1. 1.Department of SurgeryOrthopaedic UnitFinland
  2. 2.Department of PathologyFinland
  3. 3.Department of Nuclear MedicineFinland
  4. 4.Department of Diagnostic RadiologyUniversity of TurkuTurkuFinland

Personalised recommendations