Demineralized bone matrix in bone repair: History and use

Growth factors in orthopaedic surgery: demineralized bone matrix versus recombinant bone morphogenetic proteins

“…A similar window effect with better osteoinduction is noted between 41 and 50 years for men and 51 and 60 years for women [64], while no difference was recorded between 133 men and 115 women, the youngest is equivalent to the 85 years old [68]. Gruskin et al [5] conclude to a consensus on an arbitrary limit for the donors up to 70 years.…”

“…The size of the grain has an effect as the optimal granulometry seems to be between 420 and 840 μm [5].…”

“…Industries also processed DBM but usually in association with carrier, some of them are supposed to have additional properties to promote osteogenesis. Presently, at least 15 companies propose no less than 35 derived products [5,62]. In the following review on an arbitrary base, we mention as example only three of those products (Grafton® Putty, Osteotech; DBX® Putty, MTF/Synthes; Allomatrix® Injectable Putty, Wright Medical Technology).…”

“…However, the specific conditions in vitro cannot simulate the complex in vivo environment of bone, and the in vivo trials on animals show different sensitivities that do not represent a reliable evaluation of the effects on human subjects. While an in vitro or in vivo biological assay may be theoretically an ideal evaluation of the osteoinductive properties of DBM or BMP, no one is presently available to predict the clinical outcome [4,5,[23][24][25].…”

“…The final sterilisation may have a secondary toxic effect or alteration of the osteoinduction if ethylene oxide, glutaraldehyde or formaldehyde is used while merthiolate, gamma irradiation (≤25kGray) or electron beams preserve the osteoinductive properties [5,24,[78][79][80][81][82].…”