Impaction bone-grafting increases the holding power of cancellous screws in the femoral head : A pull-out study in human cadaver hips

• Published in: Acta orthopaedica 1999, Vol.70 (1), p.25-28, Article 25
• Main Authors: Lenzner, Aleks, Kaur, Llmar, Haviko, Tiit, Sogel, Velio, Gapejeva, Jelena, Ereline, Jaan, Pääsuke, Mati
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Bone Density; Bone Matrix - transplantation; Bone Screws; Bone Transplantation - methods; Cadaver; Femoral Neck Fractures - surgery; Femur Head - pathology; Femur Head - surgery; Humans; Medical sciences; Middle Aged; Prosthesis Failure; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Technology. Biomaterials. Equipments; Tensile Strength
• ISSN: 1745-3674; 0001-6470; 1745-3682
• DOI: 10.3109/17453679909000952

We studied the effect of impaction of fresh cancellous bone or demineralized bone matrix (DBM) around cancellous screws in 25 cadaver femoral heads. The bone mineral content (BMC) of femoral heads was measured to determine if greater relative increase in holding power will be achieved by impac-tion-grafting, as the BMC of the specimen decreases. A 60% (p < 0.001) relative increase in the pull-out force was achieved by impaction-grafting with DBM, compared to non-grafted controls. The augmenting effect of fresh cancellous bone graft and DBM did not differ significantly. The relative improvement in holding power was not inversely correlated to femoral head BMC, but was inversely related to the pull-out resistance of non-grafted control screws. These findings suggest that impaction-grafting provides significantly better hold of cancellous screws in femoral heads.