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WHY ONLY FEMORAL HEAD? IS THERE A FURTHER SOURCE OF BONE ALLOGRAFT?



Abstract

Revision hip surgery is becoming increasingly common, 300 procedures being performed in 2001 at our institution. In order to achieve a good outcome bone stock needs to be of good quantity frequently necessitating the use of impaction bone grafting using allograft bone.

Donor bone may frequently take three months before it becomes available for use due to the stringent screening procedure. Donor patients must have a clean bill of health, swabs taken at the time of surgery must obviously demonstrate no growth and blood samples taken at donation and an interval of three months, free from viral infectious diseases. It is thus easy to see the lag from the time of donation to availability and why, with increasing demand, need for allograft bone is rapidly exceeding supply.

We need to look for an alternative supply of human bone allograft.

We have compared the harvest of bone at the time of primary total knee replacement with that of the femoral head by both mass and volume. Sixty consecutive patients undergoing primary hip or knee arthroplasty were included in the study, and the masses and volume of the femoral heads compared with that of the total bone cuts in knee arthroplasty. The type of knee replacement used was documented as was whether the femoral head had had a bone block removed. It was found that the mass of femoral heads was 81g, that of knee cuts 95g this is a statistically significant difference; the volume of femoral heads 66ml and that of knee cuts 75ml.

The volumes of bone available from knee arthroplasty cuts are at least comparable femoral heads obtained using hip replacement and could, perhaps, provide a realistic source of bone allograft.

The abstracts were prepared by Mr Peter Kay, Editorial Secretary. Correspondence should be addressed to British Hip Society, The Hip Centre, Wrightington Hospital, Appley Bridge, Wigan, Lancashire WN6 9EP.