Tricalcium-Phosphate/Hydroxyapatite Bone Graft Extender for Use in Impaction Grafting Revision Surgery - An in Vitro Study in Human Femora

Impacted morsellised allografts have successfully been used to address the problem of poor bone stock in revision surgery. However, concern exists about pathogen transmission, high cost and shortage of supply of donor bone. Bone graft extenders, such as tricalciumphosphate (TCP) and hydroxyapatite (HA), have been developed to minimize the use of donor bone. In a human cadaver model we evaluated the surgical and mechanical feasibility of a TCP/HA bone graft extender during impaction grafting revision surgery. TCP/HA allograft mix increased the risk of producing a fissure in the femur during the impaction procedure, but provided a higher initial mechanical stability as compared to bone graft alone (subsidence ratio graft : TCP/HA = 2.34). If surgeons are properly trained, this type of graft extender can be viable for impaction grafting revision surgery.