1. Homologous morcelized defatted bone graft additionated with antibiotic and PMMA “in vivo”: preliminary histologic evaluation.
G. Gualdrini.
Rizzoli Institute
VII Department of Orthopaedic and Traumatology
Orthopaedic Clinic - University of Bologna - Italy
Director prof. Armando Giunti

2. 1947 De Grood M.
1980 McCollum D.E.
1982 Roffmann M.
1984 Sloof T.
1985 Ling R.
1987 Oakeshott R.
1991 Oliver H.
1993 Gie GA.
1994 Schreurs B.W.

3. 1996 Hovelius e Ullmark
“Impacted morselized allograft and cement for revision total knee arthroplasty” Acta Orthop. Scand. 1996
l’osso spongioso per la sua architettura può essere più facilmente penetrato dai vasi che apportano osteoblasti e depositano osteoide direttamente sulle trabecole senza che queste vengano riassorbite (GOLDBERG E STEVENSON 1987).

4. 1998 Bone Bank Rizzoli Institute
Omologous morcelized defatted bone graft

6.
Chips 3 mm

7. Thorèn K.: “Lipid-extracted bone graft”, 1994.
2.5 MRad

8. three sterile envelops 25 kGy,
- 80° C,

9. 4 weeks With G. Ullmark kind permit
1 MESE: OSTEOCITI NELLE LACUNE DELL’INNESTO, NEOAPPOSIZIONE OSSEA (in rosa + chiaro) ATTORNO TESSUTO FIBROSO CON NEOANGIOGENESI
3-4 MESI: TESS. FIBROSO ED OSTEOIDE INTORNO ALLE TRABCOLE DI TESSUTO NECROTICO
6-12 MESI: NEOFORMAZIONE OSSEA (FLUORESCENZA)
48 MESI: TESSUTO OSSEO VITALE (FOCOLAI DI EMOPOIESI)
1 MESE: OSTEOCITI NELLE LACUNE DELL’INNESTO
With G. Ullmark kind permit

10. 6 months With G. Ullmark kind permit
Assenza osteociti nell’innesto (+ scuro); più chiaro osseo neoformato con osteociti e lacune vascolari
With G. Ullmark kind permit

11. 4 years
With G. Ullmark kind permit

12. 4 years With G. Ullmark kind permit
Lacune con tessuto emopoietico, non si distingue tessuto neoformato ed innestato
With G. Ullmark kind permit

13. 10/ /2002
249 patients
82 hip p. revisions 6 knee p. revisions 13 post-trauma hip prosthesis 51 spinal fusions 50 bone lesions filling 47 long bone non-unions

14. Paprosky 2B

15. Paprosky 2B

16. Paprosky 3B
P.G., femmina 75 aa Mobilizzazione bilaterale protesi anca

18. 3 months
2 years

19. GCT

21. 12 months

22. Bone cyst
1month p.o.

23. 3 months
6 months

24. Remarks about “MOD-B” High plastic properties Loss bone-stock recovery
High resistance to septic risk
Low resistance to mechanical strenght

25. “Adsorption and release of antibiotics from morselized cancellous bone
“Adsorption and release of antibiotics from morselized cancellous bone. In vitro studies of 8 antibiotics.”
Witso E., Persen L., Loseth K., Bergh K.
Acta Orthop. Scand Jun; 70 (3):
“Vancomycin-Tobramycin composite grafts -a new treatment for chronic osteomyelytis of the neuropatic food.”
Winkler H., Berger C., Kristen K.H., Engel A.
Annual Meeting EBJIS, May 25-27, 2000 Berlin.

26. inserire rx tappari, avambracci,
Navacchia

27. G.Gualdrini, A.Bassi*, A. Giunti
Morcelized bone combined with acrylic cement enhances in vitro release of vancomycin
G.Gualdrini, A.Bassi*, A. Giunti
VII Department Orthopaedic and Traumatology
*Muscoloskeletal Tissue Bank
Rizzoli Orthopaedic Institute, Bologna.
in press

29. 16 cylinders: 10 C-A-MB : PMMA g 0. 5 + vancomycin g 0. 1 + bone g 0
16 cylinders: 10 C-A-MB : PMMA g vancomycin g bone g C-A : PMMA g vancomycin g 0.1

30. Human plasma Saline solution Four weeks 37°C

31. Antibiotic total release bone pla vs cem pla

32. Antibiotic release first week

33. Antibiotic release second-fourth week

34. “Mechanical characterization of an antibiotic cement-morcelized bone graft composite”
M.Baleani, R.Fognani, A.Toni, A.Bassi°, G.Gualdrini*
Medical Tecnology Lab.- I Orthopaedic Department
°Muscoloskeletal Tissue Bank
*VII Orthopaedic Department
Rizzoli Orthopaedic Institute, Bologna In press.

37. G.Gualdrini, A.Bassi, A.Giunti.
Homologous morcelized defatted bone graft additionated with antibiotic and PMMA “in vivo”:
preliminary histologic evaluation.
G.Gualdrini, A.Bassi, A.Giunti.

42. Remarks about “CAMB” High plastic properties Loss bone-stock recovery
Good antibiotic delivery
High resistance to mechanical loading
Good “in vivo” biocompatibility