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Logo of bmcmudisBioMed Centralsearchsubmit a manuscriptregisterthis articleBMC Musculoskeletal Disorders
 
BMC Musculoskelet Disord. 2012; 13: 187.
Published online 2012 September 25. doi:  10.1186/1471-2474-13-187
PMCID: PMC3477012
Copyright ©2012 Mittag et al.; licensee BioMed Central Ltd.
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 Mittag,1 Matthias Straub,1 Richard Schäfer,2 Torsten Kluba,corresponding author1 and Ingmar Ipach1
1Department of Orthopaedic Surgery, University Hospital Tuebingen, Hoppe-Seyler-Str 3, Tuebingen, 72076, Germany
2Institute of Clinical and Experimental Transfusion Medicine, University Hospital Tuebingen, Otfried-Mueller-Str 4/1, Tuebingen, 72076, Germany
corresponding authorCorresponding author.
Falk Mittag: falkmittag/at/med.uni-tuebingen.de; Matthias Straub: matthias.straub/at/student.uni-tuebingen.de; Richard Schäfer: richard.schaefer/at/med.uni-tuebingen.de; Torsten Kluba: torsten.kluba/at/med.uni-tuebingen.de; Ingmar Ipach: ingmar.ipach/at/med.uni-tuebingen.de
Received April 26, 2012; Accepted September 11, 2012.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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
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