Demineralized bone matrix in the stabilization of porous-coated implants in bone defects in rabbits.

Three types of grafts were investigated in rabbits to measure fixation strength of bony ingrowth into porous-coated titanium alloy implants. Autogeneic iliac crest bone (ABG), allogeneic demineralized bone matrix (DBM), and DBM augmented with fibrin glue (DBM + FG) grafts were compared with a press-fit implant control group. Initially, the ABG group required eight weeks and the DBM and DBM + FG groups 12 weeks to achieve fixation strength similar to that of the press-fit group at four weeks. Strength increased with time and at 16 weeks reached 83 kg in the ABG group, 71 kg in the DBM group, and 79 kg in the DBM + FG group, compared with 86 kg for the press-fit group. The ratio of the DBM and the DBM + FG group push-out forces to the ABG push-out force improved from 40% at four weeks to more than 80% at 16 weeks. Histologic analysis of bone ingrowth showed that at 12 weeks, bony ingrowth accounted for 21%, 22%, 16%, and 32% of the porous area in the ABG, DBM, DBM + FG, and press-fit groups, respectively. After eight weeks, there was no statistical difference between DBM, DBM + FG, and ABG grafts in either strength or bony ingrowth. The results demonstrate that over long periods, DBM grafts provide fixation stability comparable with that of autogeneic bone graft.