Natural History of Autografts and Allografts

Goldberg, Victor M.; Stevenson, Sharon

doi:10.1007/978-1-4471-1934-0_2

Cited by 260 publications

(292 citation statements)

References 1 publication

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“…To enhance osteoinduction, some surgeons have admixed autogenous bone graft and or bone marrow aspirates with allograft material, which acts as a graft extender. The sequence of histologic events in the process of allograft incorporation is similar to that described for autografts; however, the pattern of allograft incorporation is slower and less complete than that of autografts [22,25]. Once the allografts become fully incorporated they will perform in a comparable manner to autogenous bone and remodel based on mechanical demands.…”

Section: Bone Graft Materialsmentioning

confidence: 75%

Osteoinductive bone graft substitutes

2000

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Section: Bone Graft Materialsmentioning

confidence: 75%

Osteoinductive bone graft substitutes

2000

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“…Although some have shown that using highly morselized autograft fragments of cortical bone (25 lm to 2 mm, in canines) resulted in fibrous nonunion [23], benefits of smaller bone fragments have also been reported, likely arising from larger surface area [13] or better distribution of available periosteal or endosteal cells [26]. Typically, cortical autograft is gradually remodeled and replaced by regenerating bone, often delaying healing [11,12,19]. It is conceivable that use of cancellous autograft fragments may have produced better mineralization and functional recovery than observed in this study.…”

Section: Discussionmentioning

confidence: 99%

“…Autograft, surgically obtained from the patient, has persisted as the gold standard of treatment but has also been associated with a multitude of complications at the donor site, limited availability, and variation in ultimate outcomes (eg, eventual nonunion in some cases) [25,45]. Use of different harvest sites or combined use of cortical grafts with limited amounts of cancellous bone may not be sufficient to overcome these challenges and thus motivates continued investigation of alternative treatment strategies [17,19,32,45].…”

Section: Introductionmentioning

confidence: 99%

“…Allograft has reduced osteoinductive potential and slower healing, whereas demineralized scaffolds lack structural stability [1,13,19,25]. The widespread use of recombinant human BMP-2 (rhBMP-2) highlights its capability to augment large segmental bone defect repair, especially in the context of animal studies, with BMP-2 supplementation showing improved healing compared with allograft and ceramic fillers [25,46].…”

Section: Introductionmentioning

confidence: 99%

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Hydrogel-based Delivery of rhBMP-2 Improves Healing of Large Bone Defects Compared With Autograft

Krishnan

Priddy

Esancy

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Autologous bone grafting remains the gold standard in the treatment of large bone defects but is limited by tissue availability and donor site morbidity. Recombinant human bone morphogenetic protein-2 (rhBMP-2), delivered with a collagen sponge, is clinically used to treat large bone defects and complications such as delayed healing or nonunion. For the same dose of rhBMP-2, we have shown that a hybrid nanofiber mesh-alginate (NMA-rhBMP-2) delivery system provides longer-term release and increases functional bone regeneration in critically sized rat femoral bone defects compared with a collagen sponge. However, no comparisons of healing efficiencies have been made thus far between this hybrid delivery system and the gold standard of using autograft. Questions/purposes We compared the efficacy of the NMA-rhBMP-2 hybrid delivery system to morselized autograft and hypothesized that the functional regeneration of large bone defects observed with sustained BMP delivery would be at least comparable to autograft treatment as measured by total bone volume and ex vivo mechanical properties. Methods Bilateral critically sized femoral bone defects in rats were treated with either live autograft or with the NMA-rhBMP-2 hybrid delivery system such that each animal received one treatment per leg. Healing was monitored by radiography and histology at 2, 4, 8, and 12 weeks. Defects were evaluated for bone formation by longitudinal micro-CT scans over 12 weeks (n = 14 per group). The bone volume, bone density, and the total new bone formed beyond 2 weeks within the defect were calculated from micro-CT reconstructions and values compared for the 2-, 4-, 8-, and 12-week scans within and across the two treatment groups. Two animals were used for bone labeling with subcutaneously injected dyes at 4, 8, and 12 weeks followed by histology at 12 weeks to

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“…Autograft is considered the gold standard to which other grafts are compared, and the healing ability and remodeling of allografts normally are less when compared with autografts [10,11,24,28,29,33,37,59]. Bone allografts have the potential for disease transmission, although reported cases are uncommon [1,15].…”

Section: Introductionmentioning

confidence: 99%

Effects of a New Allograft Processing Procedure on Graft Healing in a Canine Model: A Preliminary Study

Beebe

Benevenia

Tuy

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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Graft healing in vivo can be affected by allograft processing. We asked whether a new processing technique influenced graft-host healing compared with autograft and a standard processing technique in a canine ulna model. We used bilateral intercalary allografts or autografts in the ulna of 13 skeletally mature male coonhounds. Each animal received two allografts, either one autograft and one allograft, or two autografts. At term (90 days), the graft sites were harvested. We assessed union with high-resolution xray imaging. Each specimen was processed for nondecalcified histologic analysis to assess the graft-host interface. Quantitative histomorphometric analysis was performed to determine spatial location and area of bone. Radiographic analysis, histologic analysis, and histomorphometric measures revealed no differences in union, mean total bone area, or total endosteal/intramedullary bone for the new process, standard process, and autografts. Our preliminary data suggest the new processing techniques may increase the safety of allograft transplantation without adversely affecting union when compared with standard processing techniques and autograft in a canine model.

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Natural History of Autografts and Allografts

Cited by 260 publications

References 1 publication

Osteoinductive bone graft substitutes

Osteoinductive bone graft substitutes

Hydrogel-based Delivery of rhBMP-2 Improves Healing of Large Bone Defects Compared With Autograft

Effects of a New Allograft Processing Procedure on Graft Healing in a Canine Model: A Preliminary Study

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