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Abstract
Allogeneic bone derived from living donors being necessary to match demand for bone transplantation and thermodisinfection of femoral heads is an established sterilization method. During the thermodisinfection the peripheral bone is exposed to maximum 86 °C for 94 min providing 82.5 °C within the center of the femoral head for at least 15 min. This study examined the compression force of the central and representative peripheral regions of native and thermodisinfected human femoral heads to observe wether different duration and intensity of heat exposure might alter mechanic behaviour. Slices from the equatorial region of human femoral heads were taken from each 14 native and thermodisinfected human femoral heads. The central area revealed a significantly higher compression force for native (p ≤ 0.001) and for thermodisinfected bone (p = 0.002 and p = 0.005) compared with peripheral regions since no relevant differences were found between the peripheral and intermediate areas themselves. A small reduction of compression force for thermodisinfected bone was shown since this did not appear significant due to the small number of specimens. The heat exposure did not alter the pre-existing anatomical changes of the microarchitecture of the native femoral heads from the center towards the peripheral regions. The heterogeneity of microstructure of the femoral head might be of interest concerning clinical applications of bone grafts since the difference between native and thermodisinfected bone appears moderate as shown previously. The different quantity of heat exposure did not reveal any significant influence on compression force which might enable thermodisinfection of preformed bone pieces for surgical indications.
Highlights
Allogeneic bone is necessary to match the growing demand for bone replacement material in orthopaedic surgery
From all measured cylinders the central specimens showed the highest compression force for native (214.7 N ± 136.1 N) (Fig. 4) and thermodisinfected (196.9 N ± 147.7 N) bone (Fig. 5) since the maximum compression force was reduced towards the peripheral areas of the slices taken from the femoral heads
For the thermodisinfected bone two out of four of the peripheral regions were significantly different from the central area of the femur since the compression force in the peripheral anterior and posterior region showed relevant lower absolute values compared with the center and the values were higher compared with the corresponding native specimens (Table 1)
Summary
Allogeneic bone is necessary to match the growing demand for bone replacement material in orthopaedic surgery. The transplantation of bone derived from femoral heads during hip replacement surgery might be regarded as gold standard (Ahmed et al 2018). The morphology of the allogeneic cancellous bone is not exactly known before surgery and several bone bank procedures apply different physical and chemical methods for preparation since native bone preserves mechanic properties. Concerning the transmission of diseases thermodisinfection of femoral heads from living donors can be regarded as a save method (Pruss et al 2003) since the impairment of mechanic properties up to 20% appears acceptable concerning its clinical use (Folsch et al 2012, 2015, 2016). Smaller specimens would increase their temperature early and different time of exposure to heat might influence mechanic parameters. Inter-site variations of bone architecture and the heterogeneity of the bone structure have to be considered (Bruyere Garnier et al 1999; Djuric et al 2013; Folsch et al 2015, 2016; Morgan et al 2004)
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