Clinical outcome and explant histology after using a cellular bone allograft in two-stage total hip arthroplasty
Shahrdar, C., McLean, J., Gianulis, E. et al.Hip
Background
Although use of cellular bone allografts (CBA) in orthopedic surgery has become increasingly common, little information is available regarding their short-term clinical performance. In these two case reports of two-stage hip arthroplasties, ViviGen Formable CBA (V-CBA) was used in stage one to fill voids left by previous metal implants.
Methods
The two patients had distinctly different health profiles, but each of them had previous metal implants due to a hip fracture. In the otherwise healthy 49-year-old male patient, the total hip arthroplasty (THA) was performed 7 weeks after nail removal and V-CBA backfill. In the 64-year-old female patient with Type 1 diabetes and severe osteoporosis, stage 2 was performed after 12 weeks. At the time of THA for each patient, bone containing some V-CBA was removed to accommodate the hip implant. The explants were histologically analyzed for bone matrix, mineralization, and neovascularization.
Results
Histological staining showed substantial new bone formation and neovascularization in both explants albeit at different levels of maturity.
Conclusions
Although limited, these results suggest that V-CBA may facilitate new bone formation in healthy as well as in metabolically challenged patients.
Level of evidence
V, case report
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