Skip to main content
Erschienen in: International Orthopaedics 8/2012

01.08.2012 | Original Paper

Reconstruction of iliac crest with bovine cancellous allograft after bone graft harvest for symphysis pubis arthrodesis

verfasst von: Konstantinos G. Makridis, Mudussar Abrar Ahmad, Nikolaos K. Kanakaris, Evangelos M. Fragkakis, Peter V. Giannoudis

Erschienen in: International Orthopaedics | Ausgabe 8/2012

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The aim of this study was to evaluate the safety and efficiency, as well as the incorporation characteristics of a specific type of xenograft used for iliac crest defects post-harvesting tri-cortical iliac crest bone graft.

Methods

Sixteen patients diagnosed with chronic anterior pelvic pain were operated for pubic symphysis fusion. The tri-cortical graft harvested from the iliac crest was inserted into the pubic symphysis and compressed with a reconstruction plate. The defect in the iliac crest was filled with a block of cancellous bovine substitute (Tutobone®). The length of iliac crest defect, time to fusion of pubic symphysis, time to incorporation of the graft and complications were recorded. The postoperative pain and patients’ satisfaction were evaluated.

Results

The median age of patients was 36.5 years (range 27–75). Fusion was obtained in 15 patients (94 %). The median time to fusion was four months (range three to seven). The length of the iliac crest bone defect ranged from 40 to 70 mm. Integration of the bovine substitute was achieved in 15 patients (94 %) over a median period of three months (range two to six). The postoperative median pain score was 2 (range 1–5). Twelve patients (75 %) reported good satisfaction. No major complications or allergic reactions were observed.

Conclusions

The xenograft used in this study provided a safe and effective method of reconstruction of iliac crest donor site defects. It has satisfactory incorporation, high biocompatibility and no signs of inflammatory reactions. This new technique is simple and easily reproducible in routine clinical practice.
Literatur
1.
Zurück zum Zitat Mazock JB, Schow SR, Triplett RG (2003) Posterior iliac crest bone harvest: review of technique, complications, and use of an epidural catheter for postoperative pain control. J Oral Maxillofac Surg: Off J Am Assoc Oral Maxillofac Surg 61:1497–1503CrossRef Mazock JB, Schow SR, Triplett RG (2003) Posterior iliac crest bone harvest: review of technique, complications, and use of an epidural catheter for postoperative pain control. J Oral Maxillofac Surg: Off J Am Assoc Oral Maxillofac Surg 61:1497–1503CrossRef
2.
Zurück zum Zitat Guerado E, Fuerstenberg CH (2011) What bone graft substitutes should we use in post-traumatic spinal fusion? Injury 42(Suppl 2):S64–S71PubMedCrossRef Guerado E, Fuerstenberg CH (2011) What bone graft substitutes should we use in post-traumatic spinal fusion? Injury 42(Suppl 2):S64–S71PubMedCrossRef
3.
Zurück zum Zitat Dimitriou R, Mataliotakis GI, Angoules AG, Kanakaris NK, Giannoudis PV (2011) Complications following autologous bone graft harvesting from the iliac crest and using the RIA: a systematic review. Injury 42(Suppl 2):S3–S15PubMedCrossRef Dimitriou R, Mataliotakis GI, Angoules AG, Kanakaris NK, Giannoudis PV (2011) Complications following autologous bone graft harvesting from the iliac crest and using the RIA: a systematic review. Injury 42(Suppl 2):S3–S15PubMedCrossRef
4.
Zurück zum Zitat Banwart JC, Asher MA, Hassanein RS (1995) Iliac crest bone graft harvest donor site morbidity. A statistical evaluation. Spine 20:1055–1060PubMedCrossRef Banwart JC, Asher MA, Hassanein RS (1995) Iliac crest bone graft harvest donor site morbidity. A statistical evaluation. Spine 20:1055–1060PubMedCrossRef
5.
Zurück zum Zitat Younger EM, Chapman MW (1989) Morbidity at bone graft donor sites. J Orthop Trauma 3:192–195PubMedCrossRef Younger EM, Chapman MW (1989) Morbidity at bone graft donor sites. J Orthop Trauma 3:192–195PubMedCrossRef
6.
Zurück zum Zitat Westrich GH, Geller DS, O'Malley MJ, Deland JT, Helfet DL (2001) Anterior iliac crest bone graft harvesting using the corticocancellous reamer system. J Orthop Trauma 15:500–506PubMedCrossRef Westrich GH, Geller DS, O'Malley MJ, Deland JT, Helfet DL (2001) Anterior iliac crest bone graft harvesting using the corticocancellous reamer system. J Orthop Trauma 15:500–506PubMedCrossRef
7.
Zurück zum Zitat Halsnad SM, Dhariwal DK, Bocca AP, Evans PL, Hodder SC (2004) Titanium plate reconstruction of the osseous defect after harvest of a composite free flap using the deep circumflex iliac artery. Br J Oral Maxillofac Surg 42:254–256PubMedCrossRef Halsnad SM, Dhariwal DK, Bocca AP, Evans PL, Hodder SC (2004) Titanium plate reconstruction of the osseous defect after harvest of a composite free flap using the deep circumflex iliac artery. Br J Oral Maxillofac Surg 42:254–256PubMedCrossRef
8.
Zurück zum Zitat Huemer GM, Puelacher W, Schoeller T (2004) Improving the iliac crest donor site by plate insertion after harvesting vascularized bone. J Craniomaxillofac Surg 32:387–390PubMedCrossRef Huemer GM, Puelacher W, Schoeller T (2004) Improving the iliac crest donor site by plate insertion after harvesting vascularized bone. J Craniomaxillofac Surg 32:387–390PubMedCrossRef
9.
Zurück zum Zitat Acharya NK, Mahajan CV, Kumar RJ, Varma HK, Menon VK (2010) Can iliac crest reconstruction reduce donor site morbidity?: a study using degradable hydroxyapatite-bioactive glass ceramic composite. J Spinal Disord Tech 23:266–271PubMedCrossRef Acharya NK, Mahajan CV, Kumar RJ, Varma HK, Menon VK (2010) Can iliac crest reconstruction reduce donor site morbidity?: a study using degradable hydroxyapatite-bioactive glass ceramic composite. J Spinal Disord Tech 23:266–271PubMedCrossRef
10.
Zurück zum Zitat Asano S, Kaneda K, Satoh S, Abumi K, Hashimoto T, Fujiya M (1994) Reconstruction of an iliac crest defect with a bioactive ceramic prosthesis. Eur Spine J 3:39–44PubMedCrossRef Asano S, Kaneda K, Satoh S, Abumi K, Hashimoto T, Fujiya M (1994) Reconstruction of an iliac crest defect with a bioactive ceramic prosthesis. Eur Spine J 3:39–44PubMedCrossRef
11.
Zurück zum Zitat Ito M, Abumi K, Moridaira H, Shono Y, Kotani Y, Minami A, Kaneda K (2005) Iliac crest reconstruction with a bioactive ceramic spacer. Eur Spine J 14:99–102PubMedCrossRef Ito M, Abumi K, Moridaira H, Shono Y, Kotani Y, Minami A, Kaneda K (2005) Iliac crest reconstruction with a bioactive ceramic spacer. Eur Spine J 14:99–102PubMedCrossRef
12.
Zurück zum Zitat Defino HL, Rodriguez-Fuentes AE (1999) Reconstruction of anterior iliac crest bone graft donor sites: presentation of a surgical technique. Eur Spine J 8:491–494PubMedCrossRef Defino HL, Rodriguez-Fuentes AE (1999) Reconstruction of anterior iliac crest bone graft donor sites: presentation of a surgical technique. Eur Spine J 8:491–494PubMedCrossRef
13.
Zurück zum Zitat Scotti C, Wirz D, Wolf F, Schaefer DJ, Burgin V, Daniels AU, Valderrabano V, Candrian C, Jakob M, Martin I, Barbero A (2010) Engineering human cell-based, functionally integrated osteochondral grafts by biological bonding of engineered cartilage tissues to bony scaffolds. Biomaterials 31:2252–2259PubMedCrossRef Scotti C, Wirz D, Wolf F, Schaefer DJ, Burgin V, Daniels AU, Valderrabano V, Candrian C, Jakob M, Martin I, Barbero A (2010) Engineering human cell-based, functionally integrated osteochondral grafts by biological bonding of engineered cartilage tissues to bony scaffolds. Biomaterials 31:2252–2259PubMedCrossRef
14.
Zurück zum Zitat Kubosch D, Milz S, Sprecher CM, Sudkamp NP, Muller CA, Strohm PC (2010) Effect of graft size on graft fracture rate after anterior lumbar spinal fusion in a sheep model. Injury 41:768–771PubMedCrossRef Kubosch D, Milz S, Sprecher CM, Sudkamp NP, Muller CA, Strohm PC (2010) Effect of graft size on graft fracture rate after anterior lumbar spinal fusion in a sheep model. Injury 41:768–771PubMedCrossRef
15.
Zurück zum Zitat Candrian C, Barbero A, Bonacina E, Francioli S, Hirschmann MT, Milz S, Valderrabano V, Heberer M, Martin I, Jakob M (2009) A novel implantation technique for engineered osteo-chondral grafts. Knee Surg Sports Traumatol Arthrosc 17:1377–1383PubMedCrossRef Candrian C, Barbero A, Bonacina E, Francioli S, Hirschmann MT, Milz S, Valderrabano V, Heberer M, Martin I, Jakob M (2009) A novel implantation technique for engineered osteo-chondral grafts. Knee Surg Sports Traumatol Arthrosc 17:1377–1383PubMedCrossRef
16.
Zurück zum Zitat Gil-Albarova J, Gil-Albarova R (2011) Donor site reconstruction in iliac crest tricortical bone graft: surgical technique. Injury. 11 Oct 2011 [Epub ahead of print] Gil-Albarova J, Gil-Albarova R (2011) Donor site reconstruction in iliac crest tricortical bone graft: surgical technique. Injury. 11 Oct 2011 [Epub ahead of print]
17.
Zurück zum Zitat Gogolewski S, Gorna K, Turner AS (2006) Regeneration of bicortical defects in the iliac crest of estrogen-deficient sheep, using new biodegradable polyurethane bone graft substitutes. J Biomed Mater Res A 77:802–810PubMed Gogolewski S, Gorna K, Turner AS (2006) Regeneration of bicortical defects in the iliac crest of estrogen-deficient sheep, using new biodegradable polyurethane bone graft substitutes. J Biomed Mater Res A 77:802–810PubMed
18.
Zurück zum Zitat Resnick DK (2005) Reconstruction of anterior iliac crest after bone graft harvest decreases pain: a randomized, controlled clinical trial. Neurosurgery 57:526–529, discussion 526–529PubMedCrossRef Resnick DK (2005) Reconstruction of anterior iliac crest after bone graft harvest decreases pain: a randomized, controlled clinical trial. Neurosurgery 57:526–529, discussion 526–529PubMedCrossRef
19.
Zurück zum Zitat Bojescul JA, Polly DW Jr, Kuklo TR, Allen TW, Wieand KE (2005) Backfill for iliac-crest donor sites: a prospective, randomized study of coralline hydroxyapatite. Am J Orthop 34:377–382PubMed Bojescul JA, Polly DW Jr, Kuklo TR, Allen TW, Wieand KE (2005) Backfill for iliac-crest donor sites: a prospective, randomized study of coralline hydroxyapatite. Am J Orthop 34:377–382PubMed
20.
Zurück zum Zitat Bapat MR, Chaudhary K, Garg H, Laheri V (2008) Reconstruction of large iliac crest defects after graft harvest using autogenous rib graft: a prospective controlled study. Spine 33:2570–2575PubMedCrossRef Bapat MR, Chaudhary K, Garg H, Laheri V (2008) Reconstruction of large iliac crest defects after graft harvest using autogenous rib graft: a prospective controlled study. Spine 33:2570–2575PubMedCrossRef
21.
Zurück zum Zitat Dave B, Modi H, Gupta A, Nanda A (2007) Reconstruction of iliac crest with rib to prevent donor site complications: A prospective study of 26 cases. Indian J Orthop 41:180–182PubMedCrossRef Dave B, Modi H, Gupta A, Nanda A (2007) Reconstruction of iliac crest with rib to prevent donor site complications: A prospective study of 26 cases. Indian J Orthop 41:180–182PubMedCrossRef
22.
Zurück zum Zitat Harris MB, Davis J, Gertzbein SD (1994) Iliac crest reconstruction after tricortical graft harvesting. J Spinal Disord 7:216–221PubMedCrossRef Harris MB, Davis J, Gertzbein SD (1994) Iliac crest reconstruction after tricortical graft harvesting. J Spinal Disord 7:216–221PubMedCrossRef
23.
Zurück zum Zitat Corrales LA, Morshed S, Bhandari M, Miclau T 3rd (2008) Variability in the assessment of fracture-healing in orthopaedic trauma studies. J Bone Joint Surg Am 90:1862–1868PubMedCrossRef Corrales LA, Morshed S, Bhandari M, Miclau T 3rd (2008) Variability in the assessment of fracture-healing in orthopaedic trauma studies. J Bone Joint Surg Am 90:1862–1868PubMedCrossRef
24.
Zurück zum Zitat Shibuya N, Jupiter DC, Clawson LD, La Fontaine J (2012) Incorporation of bovine-based structural bone grafts used in reconstructive foot surgery. J Foot Ankle Surg 51(1):30–33 Shibuya N, Jupiter DC, Clawson LD, La Fontaine J (2012) Incorporation of bovine-based structural bone grafts used in reconstructive foot surgery. J Foot Ankle Surg 51(1):30–33
25.
Zurück zum Zitat Kanakaris NK, Roberts CS, Giannoudis PV (2011) Pregnancy-related pelvic girdle pain: an update. BMC Med 9:15PubMedCrossRef Kanakaris NK, Roberts CS, Giannoudis PV (2011) Pregnancy-related pelvic girdle pain: an update. BMC Med 9:15PubMedCrossRef
26.
Zurück zum Zitat Kanakaris NK, Angoules AG, Nikolaou VS, Kontakis G, Giannoudis PV (2009) Treatment and outcomes of pelvic malunions and nonunions: a systematic review. Clin Orthop Relat Res 467:2112–2124PubMedCrossRef Kanakaris NK, Angoules AG, Nikolaou VS, Kontakis G, Giannoudis PV (2009) Treatment and outcomes of pelvic malunions and nonunions: a systematic review. Clin Orthop Relat Res 467:2112–2124PubMedCrossRef
27.
Zurück zum Zitat Sharma S, Schneider LF, Barr J, Aarabi S, Chibbaro P, Grayson B, Cutting CB (2011) Comparison of minimally invasive versus conventional open harvesting techniques for iliac bone graft in secondary alveolar cleft patients. Plast Reconstr Surg 128:485–491PubMedCrossRef Sharma S, Schneider LF, Barr J, Aarabi S, Chibbaro P, Grayson B, Cutting CB (2011) Comparison of minimally invasive versus conventional open harvesting techniques for iliac bone graft in secondary alveolar cleft patients. Plast Reconstr Surg 128:485–491PubMedCrossRef
28.
Zurück zum Zitat Delloye C, Cornu O, Druez V, Barbier O (2007) Bone allografts: What they can offer and what they cannot. J Bone Joint Surg Br 89:574–579PubMedCrossRef Delloye C, Cornu O, Druez V, Barbier O (2007) Bone allografts: What they can offer and what they cannot. J Bone Joint Surg Br 89:574–579PubMedCrossRef
29.
Zurück zum Zitat Enneking WF, Burchardt H, Puhl JJ, Piotrowski G (1975) Physical and biological aspects of repair in dog cortical-bone transplants. J Bone Joint Surg Am 57:237–252PubMed Enneking WF, Burchardt H, Puhl JJ, Piotrowski G (1975) Physical and biological aspects of repair in dog cortical-bone transplants. J Bone Joint Surg Am 57:237–252PubMed
30.
Zurück zum Zitat Enneking WF, Mindell ER (1991) Observations on massive retrieved human allografts. J Bone Joint Surg Am 73:1123–1142PubMed Enneking WF, Mindell ER (1991) Observations on massive retrieved human allografts. J Bone Joint Surg Am 73:1123–1142PubMed
31.
Zurück zum Zitat Thull R, Sturm A, Pesch H-J (1993) Mechanische Eigenschaften nativer und praparierter Spongiosa. In: Pesch H-J, Stob H, Kummer B (eds) Osteologie aktuell VII. Springer, Heideberg, pp 157–163CrossRef Thull R, Sturm A, Pesch H-J (1993) Mechanische Eigenschaften nativer und praparierter Spongiosa. In: Pesch H-J, Stob H, Kummer B (eds) Osteologie aktuell VII. Springer, Heideberg, pp 157–163CrossRef
32.
Zurück zum Zitat Patil S, Auyeung J, Gower A (2011) Outcome of subtalar fusion using bovine cancellous bone graft: a retrospective case series. J Foot Ankle Surg 50:388–390PubMedCrossRef Patil S, Auyeung J, Gower A (2011) Outcome of subtalar fusion using bovine cancellous bone graft: a retrospective case series. J Foot Ankle Surg 50:388–390PubMedCrossRef
33.
Zurück zum Zitat Lakdawala A, Todo S, Scott G (2005) The significance of surface changes on retrieved femoral components after total knee replacement. J Bone Joint Surg Br 87:796–799PubMedCrossRef Lakdawala A, Todo S, Scott G (2005) The significance of surface changes on retrieved femoral components after total knee replacement. J Bone Joint Surg Br 87:796–799PubMedCrossRef
34.
Zurück zum Zitat Meyer S, Floerkemeier T, Windhagen H (2008) Histological osseointegration of Tutobone: first results in human. Arch Orthop Trauma Surg 128:539–544PubMedCrossRef Meyer S, Floerkemeier T, Windhagen H (2008) Histological osseointegration of Tutobone: first results in human. Arch Orthop Trauma Surg 128:539–544PubMedCrossRef
Metadaten
Titel
Reconstruction of iliac crest with bovine cancellous allograft after bone graft harvest for symphysis pubis arthrodesis
verfasst von
Konstantinos G. Makridis
Mudussar Abrar Ahmad
Nikolaos K. Kanakaris
Evangelos M. Fragkakis
Peter V. Giannoudis
Publikationsdatum
01.08.2012
Verlag
Springer-Verlag
Erschienen in
International Orthopaedics / Ausgabe 8/2012
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-012-1572-z

Weitere Artikel der Ausgabe 8/2012

International Orthopaedics 8/2012 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.