Autograft, Allograft, and Bone Graft Substitutes: Clinical Evidence and Indications for Use in the Setting of Orthopaedic Trauma Surgery

Baldwin, Paul C.; Li, Deborah J.; Auston, Darryl A.; Mir, Hassan S; Yoon, Richard S.; Koval, Kenneth J.

doi:10.1097/bot.0000000000001420

Cited by 495 publications

(348 citation statements)

References 76 publications

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“…This is the reason why, nowadays, in the field of bone tissue engineering, a huge effort has been spent in searching an optimal compromise between the high required mechanical strength and the inversely proportional porosity. In accordance with the necessary features of osteoconduction and osteoinduction, several bone graft options such as autografts, allografts and bone graft substitutes are already in use in clinical procedures [43]. Nevertheless, even if currently considered as the gold standard, autograft application is limited due to donor site morbidity, supply scarcity, immunogenicity, risk of infection and injuries during harvesting.…”

Section: Scaffolds As Cell Supportmentioning

confidence: 99%

Natural and Synthetic Polymers for Bone Scaffolds Optimization

et al. 2020

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Bone tissue is the structural component of the body, which allows locomotion, protects vital internal organs, and provides the maintenance of mineral homeostasis. Several bone-related pathologies generate critical-size bone defects that our organism is not able to heal spontaneously and require a therapeutic action. Conventional therapies span from pharmacological to interventional methodologies, all of them characterized by several drawbacks. To circumvent these effects, tissue engineering and regenerative medicine are innovative and promising approaches that exploit the capability of bone progenitors, especially mesenchymal stem cells, to differentiate into functional bone cells. So far, several materials have been tested in order to guarantee the specific requirements for bone tissue regeneration, ranging from the material biocompatibility to the ideal 3D bone-like architectural structure. In this review, we analyse the state-of-the-art of the most widespread polymeric scaffold materials and their application in in vitro and in vivo models, in order to evaluate their usability in the field of bone tissue engineering. Here, we will present several adopted strategies in scaffold production, from the different combination of materials, to chemical factor inclusion, embedding of cells, and manufacturing technology improvement.

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Section: Scaffolds As Cell Supportmentioning

confidence: 99%

Natural and Synthetic Polymers for Bone Scaffolds Optimization

et al. 2020

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“…Hydroxyapatite (HA) is a calcium phosphate with composition Ca 10 (PO 4 ) 6 (OH) 2 and a Ca/P ratio of 1.67. HA presents characteristics of osteoconduction, supports bone ingrowth, and can establish chemical bonds with bone tissue, allowing the proliferation of fibroblasts, osteoblasts, and other bone cells [8].…”

Section: Introductionmentioning

confidence: 99%

Fabrication of Biocompatible Composites of Poly(lactic acid)/Hydroxyapatite Envisioning Medical Applications

Backes¹,

Pires

Beatrice

et al. 2020

Polymer Engineering & Sci

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Over the last years, orthopedic procedures for bone repairs have been developed due to an increase in trauma and diseases. The development of bioactive composites using biodegradable polymers like poly(lactic acid) (PLA) and bioactive fillers as hydroxyapatite (HA) originate biomaterials, which combine bioactivity of HA and PLA biocompatibility. Therefore, using additive manufacturing is possible for the production of customized products made from these materials; however, a thorough study of these materials is required. In this context, melt‐compounding has been used to manufacture bioactive composites of PLA/HA, and rheological, molecular, and thermomechanical behavior were assessed. The biocomposite of PLA with 10 wt% HA presented a strong shear thinning behavior, which makes it more suitable for fused filament fabrication since lower printing pressure is required. Furthermore, this composite presented an enhancement of 12% in thermomechanical properties in comparison to PLA and a slight increase in cell proliferation. PLA and PLA/HA were fabricated and used to produce 3D calibrations cube as a proof of concept. They presented good printability and high accuracy, and therefore, further investigation needs to be performed to unleash its use in bone tissue engineering applications. POLYM. ENG. SCI., 60:636–644, 2020. © 2020 Society of Plastics Engineers

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“…Cement augmented fixation has been studied and appears to have biomechanical advantages [9], as did biologic or synthetic bone substitutes [4]. Demineralized bone matrix has been used in several orthopedic trauma conditions such as in the treatment of critical size defects [10]. Allografts have also been used in several studies [11] but indication in the treatment of acute proximal humerus fractures in the elderly remains controversial.…”

Section: Introductionmentioning

confidence: 99%

Treatment of proximal humerus fractures in geriatric patients - Can pathological DEXA results help to guide the indication for allograft augmentation?

Halvachizadeh¹,

Berk²,

Rauer³

et al. 2020

PLoS ONE

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Introduction Reconstruction of proximal humerus fracture continues to represent a challenge, especially in severe osteopenia. However, there still is a lack of consensus and clear indication on use of allograft augmentation. Therefore, this study aims to investigate outcome after osteosynthesis with and without allograft augmentation. It focuses on bone density results obtained by DEXA as potential examination that might help decision-making. Methods This study included patients aged 65 years and older that were treated at one Level 1 trauma center between 2007 and 2018. Inclusion criteria: Proximal humerus fracture treated with or without allograft, conclusive data-sets. Exclusion criteria: prior surgical treatment of the proximal humerus, open fracture with bone loss, neurological damage. Patients were stratified according to the use of allograft augmentation in two groups: Group NA (no allograft augmented PHILOS) and Group A (PHILOS with allograft augmentation). Comorbidity was assessed using the Charlson Comorbidity Index (CCI). Fractures were graded according to the classification by Neer. Radiographic union was analyzed at 6 weeks, 12 weeks, and at year follow up. Complications include surgical site infection, implant failure, humeral head necrosis, or delayed union. Allograft was used in cases of 1inch/3cm 3 bone-loss or an eggshell situation, where the patient refused arthroplasty. Results This study included 167 patients, with 143 (85%) in the Group NA, and 24 (15%) in the Group A. There were no significant differences in age, gender, injury distribution, and distribution of Neer classification or CCI. Patients in Group A had significantly lower T-scores preoperatively (-2.87 ± 1.08 versus-0.9 ± 2.12, p = 0.003). No difference occurred in any of the complications. At one-year follow-up, the range of motion was comparable in both groups.

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Autograft, Allograft, and Bone Graft Substitutes: Clinical Evidence and Indications for Use in the Setting of Orthopaedic Trauma Surgery

Cited by 495 publications

References 76 publications

Natural and Synthetic Polymers for Bone Scaffolds Optimization

Natural and Synthetic Polymers for Bone Scaffolds Optimization

Fabrication of Biocompatible Composites of Poly(lactic acid)/Hydroxyapatite Envisioning Medical Applications

Treatment of proximal humerus fractures in geriatric patients - Can pathological DEXA results help to guide the indication for allograft augmentation?

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