Impaction bone-grafting increases the holding power of cancellous screws in the femoral head - A pull-out study in human cadaver hips

We studied the effect of impaction of fresh cancellous bone or demineralize d bone matrix (DBM) around cancellous screws in 25 cadaver femoral heads. T he bone mineral content (BMC) of femoral heads was measured to determine if greater relative increase in holding power will be achieved by impaction-g rafting, as the BMC of the specimen decreases. A 60% (p < 0.001) relative i ncrease in the pull-out terce was achieved by impaction-grafting with DBM, compared to non-grafted controls. The augmenting effect of fresh cancellous bone graft and DBM did not differ significantly, The relative improvement in hording power was not inversely correlated to femoral head BMC, but was inversely related to the pullout resistance of non-grafted control screws. These findings suggest that impaction-grafting provides significantly bette r hold of cancellous screws in femoral heads.