Evaluation of incorporation of bone allograft at the site of implantation in various clinical conditions along with its complications
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20202681Keywords:
Bone allograft, Spinal fusion, Non-union, Morselized, FractureAbstract
Background: Bone transplants have been used routinely in the present century for diverse purposes to unite fractures, fuse joints, and repair skeletal defects.
Methods: Twelve patients with fracture, bone defect, deformity, difficulty in the fusion of bone, etc. were taken in the study for elective surgery with fresh frozen allograft in the orthopedics department with the incorporation of inclusion and exclusion criteria.
Results: Out of 12 cases in this study, 7 cases were related to spinal fusion, 3 cases were of fractures with bone defects, 1 case of non-union neck femur fracture and 1 case was of revision hip arthroplasty with the acetabular bone defect. Seventy-five percent (9 patients) and 25% (3 patients) were graded fair and poor respectively in the preoperative phase. At 6 months, excellent results were obtained in 50% (6 patients), good in 25% (3 patients), fair in 25% (3 patients), while none were graded as poor in terms of clinical evaluation.
Conclusions: Fresh frozen bone, a good source of abundant bone allograft, can be stored in -70° freezer for use in orthopedic surgery to fill any filling defect in the bone. Also, proper storage, better surgical technique, hospital infection control policy, antibiotic policy, preoperative use of antibiotics before surgery has a good clinical outcome.
References
Alencar DPG, Vieira IF. Bone banks. Rev Bras Ortop. 2015;45(6):524‐8.
Friedlander GE. Bone banking in support of reconstructive surgery of the hip. Clin Orthop Relat Res. 1987;225:17-21.
Friedlander GE. Bone Grafts - the basic science rationale of clinical application. J Bone Joint Surg Am. 1987;69(5):786-90.
Malinin TI, Martinez OV, Brown MD. Banking of Massive Osteoarticular and intercalary bone allografts - 12 years’ experience. Clin Orthop Relat Res. 1985;197:44-57.
Malenin TI, Wagner JL, Pito J, Lo H. Hypothermic Storage and cryopreservation of cartilage - an experimental study. Clin Orthop Relat Res. 1985;197:15-26.
Tomford WW, Mankin HJ, Friedlander GE, Doppelt S, Gebherdt MC. Methods of banking bone and cartilage for allograft transplantation. Orthop Clin North Am. 1987;18(2):241-7.
Goldberg VM, Stevenson S. Natural history of Autografts. Clin Orthop Relat Res. 1987;225:7-16.
Bauer TW, Muschler F. Bone graft material, an overview of the Basic Science. Clin Orthop. 2000;371:10-27.
Shukla S, Malhotra R, Bhan S. Results of fresh frozen bone allografts in orthopaedics. Indian J Orthop. 2003;37:8.
Roudbari S, Sami HAS, Roudbari M. The clinical results of benign bone tumor treatment with allograft or autograft. Arch Iran Med. 2015;18(2):109-13.
Mankin HJ, Gebhardt MC, Jennings LC, Springfield DS, Tomford WW. Long term Results of Allograft replacement in the management of bone tumors. Clin Orthop. 1996;324:86-97.
Conn RA, Paterson LFA, Stauffer RN, Ilstrup D. Management of acetabular deficiency. Long term results of bone grafting of acetabulum in THR. Orthop Trans. 1985;9:451-2.
Sethi A, Aggarwal K, Tulsi SM, Sethi S, Kumar S, Maurya SK. Allografts in treatment of Benign Cystic Lesions of Bone. Arch Orthop Trauma Surg. 1993;112(4):167-70.
Goel SC, Tuli SM, Singh HP, Sharma SV, Saraf SK, Srivastava TP. Allogenic decalcified Bone in Repair of Benign Cystic lesions of Bone. Int Orthop. 1992;16(2):176-9.
Borja FJ, Mnaymneh W. Bone allografts in salvage of difficult hip arthroplasties. Clin Orthop. 1985;197:23.
Mulhim AFA, Baragbah MA, Ali SM, Alomran AS, Azam MQ. Prevalence of Surgical Site Infection in Orthopedic Surgeries, 5 years analysis. Int Surg. 2014;99(3):264-8.
Peersman G, Laskin R, Davis J, Peterson GE, Richart T. Prolonged Operative Time Correlates with Increased Infection Rate after Total Knee Arthroplasty. HSS J. 2006;2(1):70-2.
Wu C, Hsieh P, Jiang JF, Shih H, Chen C, Hu C. A positive bacterial culture from allograft bone at implantation does not correlate with subsequent surgical site infection. J Bone Joint. 2015;97:427-31.
Mankin HJ, Doppelt S, Tomford W. Clinical experience with allograft implantation, the first ten years. Clin Orthop. 1983;174:69-86.
Lord CF, Gebhardt MC, Tomford WW, Mankin HJ. Infection in bone allografts. Incidence, nature, and treatment. J Bone Joint Surg Am. 1988;70(3):369-76.
Chang Y, Shih HN, Chen DW, Lee MS, Ueng SW, Hsieh PH. The concentration of antibiotics in fresh-frozen bone allograft. J Bone Joint Surg Br. 2010;92:1471-4.
Tomford WW, Ploetz JE, Mankin HJ. Bone allografts of femoral heads - procurement and storage. J Bone Joint Surg Am. 1986;68(4):534-7.
Sommerville SM, Johnson N, Bryce SL, Journeaux SF, Morgan DA. Contamination of banked femoral head allograft: incidence, bacteriology and donor follow up. Aust N Z J Surg. 2000;70:480-4.
Cunha BA, Gossling HR, Pasternak HS, Nightingale CH, Quintiliani R. The penetration characteristics of cefazolin, cephalothin, and cephradine into bone in patients undergoing total hip replacement. J Bone Joint Am. 1977;59:856-9.
Kong CG, Kim YY, Park JB. Post-operative changes of early-phase inflammatory indices after uncomplicated anterior cervical discectomy and fusion using allograft and demineralised bone matrix. Int Orthop. 2012;36(11):2293-7.
Larsson S, Thelander U, Friberg S. C-reactive protein (CRP) levels after elective orthopedic surgery. Clin Orthop Relat Res. 1992;275:237-42.
Kubosch EJ, Bernstein A, Wolf L, Fretwurst T, Nelson K, Schmal H. Clinical trial and in-vitro study comparing the efficacy of treating bony lesions with allografts versus synthetic or highly-processed xenogeneic bone grafts. BMC Musculoskelet Discord. 2016;17:118.
Enneking WF, Spanier SS, Goodman MA. Current concept review: The surgical staging of musculoskeletal sarcoma. J Bone Joint Surg Am. 1989;62A:1027-30.
Mankin HJ, Gebherdt MC, Tomford WW. The use of frozen cadaveric allografts in the management of patients with bone tumors of the extremities. Orthop Clin North Am. 1987;18(2):275-90.