Biomechanical experimental substantiation of the fixation technique of bone allograft and recipient’s bone
DOI:
https://doi.org/10.15674/0030-59872020140-45Keywords:
allocomposite replacement, reparative osteogenesis, femur, rats, biomechanical strength studyAbstract
A technique combining bone allografting and arthroplasty — allocomposite replacement (ACR), is widely used in orthopedic oncology. However, the risk of complications after this surgical intervention remains high — non-union of the allograft with the recipient's bone, its lysis, infection.
Objective: to substantiate ACR techniques biomechanically using segmental bone allografts with intramedullary fixation in the recipient’s bone. Methods: the experiment was performed on 28 male rats (age 5 months, body weight 350–400 g). ACR of the femur was modeled with transverse (I group) and stepcut (II) osteotomy. The strength of the isolated preparations of the operated animal femurs was examined on a biomechanical stand after 3 and 6 months after the surgery. Digital indicators are processed statistically.
Results: in the Ist group of animals (3 months after surgery) the strength of the operated bones was statistically significantly lower compared to the contralateral (t = –2.674; p = 0.037), and in rats with stepcut osteotomy the difference was not significant. In 6 months after surgery, bone strength with stepcut osteotomy was found to be (44.3 ± 15.6) N greater than with transverse (t = –2.838; p = 0.023). At the same time, the strength of the operated bones of animals of the Ist group was comparable with that of the contralateral limbs (t = –1.279; p = 0.248), and in the IInd exceeded them (t = 6,000; p = 0.001).
Conclusions: stepcut osteotomy with subsequent fixation of the bone allograft to the recipient’s bone improves the conditions for reparative osteogenesis in the area of their contact and reduces the risk of ACR complications. Bioreconstructive surgical interventions in order to replace post-resection defects of long bones in patients with tumor lesions can improve orthopedic, functional and oncological treatment results.
References
- Hornicek, F. J., Gebhardt, M. C., Tomford, W. W., Sorger, J. I., Zavatta, M., Menzner, J. P., & Mankin, H. J. (2001). Factors affecting Nonunion of the allograft-host Junction. Clinical Orthopaedics and Related Research, 382, 87-98. https://doi.org/10.1097/00003086-200101000-00014
- Gharedaghi, M., Peivandi, M. T., & Mazloomi, M. (2016). Evaluation of clinical results and complications of structural allograft reconstruction after bone tumor surgery. The Archives of Bone and Joint Surgery, 4(3), 236-242
- Mayle Jr, R. E., & Paprosky, W. G. (2012). Massive bone loss. The Journal of Bone and Joint Surgery. British volume, 94-B(11_Supple_A), 61-64. https://doi.org/10.1302/0301-620x.94b11.30791
- Benedetti, M. G., Bonatti, E., Malfitano, C., & Donati, D. (2013). Comparison of allograft-prosthetic composite reconstruction and modular prosthetic replacement in proximal femur bone tumors. Acta Orthopaedica, 84(2), 218-223. https://doi.org/10.3109/17453674.2013.773119
- Biau, D. J., Larousserie, F., Thévenin, F., Piperno-Neumann, S., & Anract, P. (2009). Results of 32 allograft-prosthesis composite reconstructions of the proximal femur. Clinical Orthopaedics and Related Research®, 468(3), 834-845. https://doi.org/10.1007/s11999-009-1132-z
- Ippolito, J. A., Martinez, M., Thomson, J. E., Willis, A. R., Beebe, K. S., Patterson, F. R., & Benevenia, J. (2019). Complications following allograft reconstruction for primary bone tumors: Considerations for management. Journal of Orthopaedics, 16(1), 49-54. https://doi.org/10.1016/j.jor.2018.12.013
- Liebschner, M. A. (2004). Biomechanical considerations of animal models used in tissue engineering of bone. Biomaterials, 25(9), 1697-1714. https://doi.org/10.1016/s0142-9612(03)00515-5
- Vyrva, O. E., Delevsky, Yu. P., Kladchenko, L. A., & Dimitrova, N. V. (2002). Analysis of the use of bone allografts in clinical practice. Orthopedics, traumatology and prosthetics, 2, 57-61. [in Russian]
- European Convention for the protection of vertebrate animals used for research and other scientific purposes. Strasbourg, 18 March 1986: official translation. [Electronic resource]. Retrieved from: http://zakon.rada.gov.ua/cgi-bin/laws/main. cginreg=994_137. [in Ukrainian]
- On protection of animals from cruel treatment: Law of Ukraine № 3447-IV of 21.02.2006. [Electronic resource]. Retrieved from: http://zakon.rada.gov.ua/cgi-bin/laws/ main.cgi?nreg=3447-15. [in Ukrainian]
- Vyrva, O. E., Golovina, Ya. O., & Malik, R. V. (2017). Experimental-histological study of reparative osteogenesis under conditions of different methods of allograft fixation during allocomposite endoprosthesis of long bones. Orthopedics, traumatology and prosthetics, 2, 70-77. DOI: 10.15674/0030-59872017270-77. [in Ukrainian]
- Nasledov, A. (2011). SPSS 19: Professional Statistical Data Analysis. Saint Petersburg: Piter. [in Russian]
- Vyrva, O. E., Golovina, Ya. O., & Malik, R. V. (2019). Method of modeling the method of fixation of the implanted allocomposite endoprosthesis of the proximal femur. UA. Patent 137301. [in Ukrainian]
- Dubina, A., Shiu, B., Gilotra, M., Hasan, S. A., Lerman, D., & Ng, V. Y. (2017). What is the optimal reconstruction option after the resection of proximal humeral tumors? A systematic review. The Open Orthopaedics Journal, 11(1), 203-211. https://doi.org/10.2174/1874325001711010203
- Zimel, M. N., Farfalli, G. L., Zindman, A. M., Riedel, E. R., Morris, C. D., Boland, P. J., & Healey, J. H. (2015). Revision distal femoral arthroplasty with the compress® prosthesis has a low rate of mechanical failure at 10 years. Clinical Orthopaedics and Related Research®, 474(2), 528-536. https://doi.org/10.1007/s11999-015-4552-y
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