The Relevance of Physical Characterisation in the Evaluation of the Performance of Bone Allografts

Judas, F; Proença, Ana Luísa; Moura, Marcela Oliveira Caldeira de; Piedade, Ana P.; Figueiredo, Margarida

doi:10.4028/www.scientific.net/kem.230-232.467

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“…Previous studies have been shown that mineralized cancellous bone graft, as compared to demineralized cortical bone, not only reveal a higher porosity but also a wider pore size distribution, which is much more favourable for early bone regeneration. 8 On the other hand, the production of a large fracture surface area, by microfracturing the bone during morselization, they expose the bone matrix to surrounding tissues 9 and the impaction technique release bone growth factors from the cancellous bone graft.…”

Section: Discussionmentioning

confidence: 99%

Incorporation of Impacted Morselized Bone Allografts in Rabbits

Judas¹,

Figueiredo²,

Cabrita³

et al. 2005

Transplantation Proceedings

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Morselized bone allografts have been used for the treatment of bone stock loss in orthopedic revision surgery with encouraging results. However, several parameters can influence the graft incorporation including the processing treatments. This experimental work used a cavitary bone defect in 90 rabbits to evaluate the sequence of incorporation of three different kinds of morselized bone allografts: uncryopreserved cancellous bone, freeze-dried cancellous bone, and totally demineralized cortical bone each of which were prepared in accordance with our rigid protocol. Revascularization and remodeling of the transplanted bone grafts were evident upon histological evaluation. Bone apposition and bone resorption resulted in a mixture of graft and new bone. Mineralized cancellous grafts showed great osteoconductive capacity, whereas demineralized cortical grafts showed an intense osteoinductive capacity and a weak osteoconductive capacity. In a general evaluation, cryopreserved cancellous bone grafts showed superior biological efficacy for reconstruction of experimental bone defects, closely followed by freeze-dried cancellous bone grafts, and, finally, by demineralized cortical bone grafts. These results validate our protocol for the processing and preservation of these three kinds of bone grafts. B ONE STOCK LOSS is the main problem for revision surgery of a failed total hip prosthesis. In our institution, impacted morselized bone allografts are frequently used in conjunction with a roof reinforcement ring for acetabular reconstruction and a cementless stem on the femoral side, even in large cavitary defects. Initially, these defects were filled with bone cement but it soon became clear that the failure rate of this technique was unacceptably high. Although the reconstruction of the osteolyses induced by aseptic loosening of hip prosthesis with impacted morselized cancellous allografts had demonstrated satisfactory results, 1-4 controversy still exists about the best approach to these bone stock deficiencies. It is recognized that, in addition to the surgical technique, the methods of bone allograft processing, preservation, and sterilization can alter both its initial physical and chemical properties and their immune response, as well as endanger the mechanical stability of the surgical reconstruction, 5 concomitantly influencing the biological behavior of the allografts.This study evaluated the incorporation sequence of three different kinds of morselized bone allografts-cryopreserved cancellous bone, freeze-dried cancellous bone, and totally demineralized cortical bone-prepared in accordance with our current protocol. An experimental model was developed using a cavitary bone defect in rabbits. The impacted bone allografts were placed into the cancellous bone of the rabbit knee under mechanical stability conditions. MATERIALS AND METHODS Preparation of Graft MaterialAll bone grafts were harvested from donor Californian rabbits using standard aseptic techniques. The cancellous bone was harvested from the fem...

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Section: Discussionmentioning

confidence: 99%