Sterilization of Preserved Bone Grafts by High-Voltage Cathode Irradiation

Turner, Thomas C.; Bassett, C. A. L.; Pate, James W.; Sawyer, Philip N.; Trump, John G.; Wright, Kenneth W.

doi:10.2106/00004623-195638040-00015

Cited by 44 publications

(11 citation statements)

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“…In 1985, improvement in bone bank procedures [19] and the possibility of sterilising bone [1,29] led us to use gamma irradiation sterilised bone allografts. From 1985 to the end of 1990, 164 sterilised massive allografts were implanted.…”

Section: Methodsmentioning

confidence: 99%

Infection in massive bone allografts sterilised by radiation

Loty

Toméno

Evrard

et al. 1994

International Orthopaedics

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Massive bone allografts sterilised by radiation have been used in our hospital since 1985. The 164 consecutive reconstructions which we carried out before December 1990 were in equal part for tumour resections and revision arthroplasties associated with major bone defects. The allografts were used as intercalary or composite graft-prosthesis reconstructions. Fourteen (8.5%) skin sloughs or infections occurred, all but one after operations for malignant tumours. The grafts never appeared to be responsible. Infection after malignant tumour resection most commonly occurred at the knee when preoperative radiation had been used. Twenty-five reconstructions were performed in the presence of infection, which only recurred in one case. Twelve infections were treated, but 2 other patients died for other reasons within a year. One patient had to have an amputation and one had persistent infection. In the other cases, the infection healed. Only two debridements alone were successful. Removal of the graft and replacement with antibiotic-loaded cement was the most effective treatment.

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Section: Methodsmentioning

confidence: 99%

Infection in massive bone allografts sterilised by radiation

Loty

Toméno

Evrard

et al. 1994

International Orthopaedics

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“…24 The operation can be carried out as a single [19][20][21][23][24][25][26] or as a two-step procedure with intermediate positioning of a spacer 22 depending on the facilities for irradiation which are available. The required dose for safe devitalisation or inactivation of a tumour is not established but large doses of irradiation in the order of megarads, which are considered necessary for sterilisation, 28,29 will cause damage to the structure of the bone protein 30 and therefore may not be the minimal essential dose. 31 Little systematic work has been undertaken to evaluate the incorporation of irradiated autologous grafts or the function of the affected limbs.…”

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confidence: 99%

Influence of extracorporeal irradiation on the reintegration of autologous grafts of bone and joint

Sabo¹,

Brocai

Eble

et al. 2000

The Journal of Bone and Joint Surgery. British volume

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We studied the effects of irradiation on the reintegration of autologous osteoarticular grafts over a period of 24 weeks in a canine model. In 16 foxhounds the medial femoral condyle was resected, irradiated and immediately replanted. In the control group resection and replantation were performed without irradiation. Reintegration was assessed by macroscopic analysis, histology, radiography and gait analysis.Reintegration was equal at 12 weeks, but significantly inferior in the irradiated group after 24 weeks with delayed bone remodelling. The articular cartilage showed modest degeneration. Conventional radiography and histology showed corresponding changes. Limb function was adequate but the gait was inferior in the treated group.J Bone Joint Surg [Br] 1999;81-B:276-82.

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“…Application of the same doses but given in the sequential fashion of radiation followed by heat also caused marked inactivation of HIV and had less effect on the mechanical strength of the bone. n Among the different methods of bone sterilization, irradiation is one of the most popular (Turner et al 1956, de Vries et al 1958, Wright and Trump 1970, Hernigou et al 1993) and several authors have reported the radiosensibility of human immunodeficiency virus (Spire et al 1985, Kitchen et al 1989, Conway et al 1990, Campbell et al 1994. In all studies, the dose required for inactivation of the virus has been calculated in frozen allografts.…”

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confidence: 99%