Clinical outcome and explant histology after using a cellular bone allograft in two-stage total hip arthroplasty

J Orthop Surg Res. 2020 Jan 16;15(1):16. doi: 10.1186/s13018-020-1542-x.

Abstract

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.

Keywords: Allograft; Bone regeneration; Bone void filler; Osteoblasts; Osteogenic; Total hip arthroplasty.

Publication types

  • Case Reports

MeSH terms

  • Arthroplasty, Replacement, Hip*
  • Bone Transplantation*
  • Bone and Bones / anatomy & histology*
  • Cell Transplantation*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Osteogenesis*