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Open Access Research article

No red cell alloimmunization or change of clinical outcome after using fresh frozen cancellous allograft bone for acetabular reconstruction in revision hip arthroplasty: a follow up study

Falk Mittag1, Matthias Straub1, Richard Schäfer2, Torsten Kluba1* and Ingmar Ipach1

Author Affiliations

1 Department of Orthopaedic Surgery, University Hospital Tuebingen, Hoppe-Seyler-Str 3, Tuebingen, 72076, Germany

2 Institute of Clinical and Experimental Transfusion Medicine, University Hospital Tuebingen, Otfried-Mueller-Str 4/1, Tuebingen, 72076, Germany

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BMC Musculoskeletal Disorders 2012, 13:187  doi:10.1186/1471-2474-13-187

Published: 25 September 2012

Abstract

Background

Possible immunization to blood group or other antigens and subsequent inhibition of remodeling or incorporation after use of untreated human bone allograft was described previously. This study presents the immunological, clinical and radiological results of 30 patients with acetabular revisions using fresh frozen non-irradiated bone allograft.

Methods

AB0-incompatible (donor-recipient) bone transplantation was performed in 22 cases, Rh(D) incompatible transplantation in 6 cases. The mean follow up of 23 months included measuring Harris hip score and radiological examination with evaluation of remodeling of the bone graft, implant migration and heterotopic ossification. In addition, all patients were screened for alloimmunization to Rh blood group antigens.

Results

Compared to the whole study group, there were no differences in clinical or radiological measurements for the groups with AB0- or Rh(D)-incompatible bone transplantation. The mean Harris Hip Score was 80.6. X-rays confirmed total remodeling of all allografts with no acetabular loosening. At follow up, blood tests revealed no alloimmunization to Rh blood group donor antigens.

Conclusions

The use of fresh frozen non-irradiated bone allograft in acetabular revision is a reliable supplement to reconstruction. The risk of alloimmunization to donor-blood group antigens after AB0- or Rh-incompatible allograft transplantation with a negative long-term influence on bone-remodeling or the clinical outcome is negligible.

Keywords:
Acetabular revision; Allograft bone; Remodeling; Alloimmunization; AB0; Rhesus