Mechanical considerations in impaction bone grafting

N.T. Brewster, W.J. Gillespie, C.R. Howie, S.P.G. Madabhushi, Asif Sohail Usmani, D.R. Fairbairn

Research output: Journal article publicationJournal articleAcademic researchpeer-review

143 Citations (Scopus)

Abstract

In impaction grafting of contained bone defects after revision joint arthroplasty the graft behaves as a friable aggregate and its resistance to complex forces depends on grading, normal load and compaction. Bone mills in current use produce a distribution of particle sizes more uniform than is desirable for maximising resistance to shear stresses. We have performed experiments in vitro using morsellised allograft bone from the femoral head which have shown that its mechanical properties improve with increasing normal load and with increasing shear strains (strain hardening). The mechanical strength also increases with increasing compaction energy, and with the addition of bioglass particles to make good the deficiency in small and very small fragments. Donor femoral heads may be milled while frozen without affecting the profile of the particle size. Osteoporotic femoral heads provide a similar grading of sizes, although fewer particles are obtained from each specimen. Our findings have implications for current practice and for the future development of materials and techniques.
Original languageEnglish
Pages (from-to)118-124
Number of pages7
JournalJournal of Bone and Joint Surgery - Series B
Volume81
Issue number1
DOIs
Publication statusPublished - 1 Jan 1999
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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