This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Letters to the Editor: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Letters to the Editor are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowReprints and Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by VIROLAINEN, P.
Right arrow Articles by CHAO, E. Y. S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by VIROLAINEN, P.
Right arrow Articles by CHAO, E. Y. S.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Technorati  
What's this?
The Journal of Bone and Joint Surgery 81:493-9 (1999)
© 1999 The Journal of Bone and Joint Surgery, Inc.

Autogenous Onlay Grafting for Enhancement of Extracortical Tissue Formation Over Porous-Coated Segmental Replacement Prostheses*

PETRI VIROLAINEN, M.D., PH.D.{dagger}, NOZOMU INOUE, M.D., PH.D.{dagger}, MASATO NAGAO, M.D., PH.D.{dagger}, ISAO OHNISHI, M.D., PH.D.{dagger}, FRANK FRASSICA, M.D.{dagger} and EDMUND Y. S. CHAO, PH.D.{dagger}, BALTIMORE, MARYLAND

Investigation performed at the Orthopaedic Biomechanics Laboratory, Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore

Background: Prosthetic reconstruction with extracortical bone-bridging is an effective method of limb salvage after resection of a malignant or locally invasive benign bone tumor. Use of cancellous bone graft alone is less effective in achieving extracortical bone-bridging. The present study was performed to investigate the effects of a corticocancellous onlay graft on bone and soft-tissue formation over a porous-coated replacement prosthesis in the mid-diaphyseal region of canine femora. Methods: Bilateral resection of a six-centimeter segment of the femoral diaphysis and reconstruction with a porous-coated segmental prosthesis was performed in six mongrel dogs. In one limb (the experimental side), eight strips of corticocancellous bone were evenly placed around the junctions between the femur and the prosthetic surface. Cancellous bone was placed under and between the strips of cortical bone. No graft was used in the other limb (the control side). The animals were followed for twelve weeks, with sequential assessments of load-bearing and radiographic evaluation. Biomechanical, histological, and microradiographic analyses of the specimens were performed after death. Results: On the control side, load-bearing at four weeks postoperatively was significantly decreased compared with the preoperative value (p < 0.05); no difference in these values could be detected on the experimental side. Both the area of the callus and the contact area between the bone and the prosthetic shoulder were greater on the experimental side (p < 0.05). The mechanical stiffness and the maximum torque at failure of the extracortical bridging tissue across the junction between the bone and the prosthetic shoulder were eighteen (p < 0.007) and five times greater (p < 0.05), respectively, on the experimental side. Conclusions: Extracortical bone-bridging was accomplished with corticocancellous onlay bone-grafting. Without bone-grafting, bone formed only occasionally. Bone-grafting also enhanced the formation of a soft-tissue capsule around the prosthesis.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Technorati Technorati    What's this?


This article has been cited by other articles:


Home page
 JBJSHome page
J. Fukuroku, N. Inoue, B. Rafiee, F. H. Sim, F. J. Frassica, and E. Y.S. Chao
Extracortical Bone-Bridging Fixation with Use of Cortical Allograft and Recombinant Human Osteogenic Protein-1
J. Bone Joint Surg. Am., July 1, 2007; 89(7): 1486 - 1496.
[Abstract] [Full Text] [PDF]

Home page
 JBJSHome page
E. Y.S. Chao, B. Fuchs, C. M. Rowland, D. M. Ilstrup, D. J. Pritchard, and F. H. Sim
Long-Term Results of Segmental Prosthesis Fixation by Extracortical Bone-Bridging and Ingrowth
J. Bone Joint Surg. Am., May 1, 2004; 86(5): 948 - 955.
[Abstract] [Full Text] [PDF]