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Musculoskeletal Tissue Regeneration pp 81–92Cite as

Biology of Bone Allograft and Clinical Application

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Part of the book series: Orthopedic Biology and Medicine ((OBM))

Abstract

Bone allografts have become an accepted technology to replace bone loss as a result of tumor resection, trauma and failed total joint ar-throplasty. Since fresh allograft invokes an immune rejection response, bone is usually processed by freezing or freeze-drying to reduce the immune response. The significance of biological events of incorporation include hemorrhage and inflammation, osteogenesis, osteoinduction, osteoconduction and effective remodeling to become a load bearing structure. The clinical parameters that enhance the chance of successful bone allograft incorporation are adherence to the American Association of Tissue Bank standards, appropriate graft selection for the clinical application, stable graft-host interface and preservation of the surrounding soft tissue and host blood supply. Cancellous allografts are usually completely incorporated, while cortical grafts remain an admixture of viable new bone and necrotic old bone for a prolonged period of time. Massive bone allografts used for reconstruction of the tumor resection have a long term successful outcome in about 80 percent of the procedures. Similar success is reported for its use in total joint revision surgery and other clinical applications.

The major complications reported for grafting procedures are infection, bone graft fracture, nonunion at the graft-host juncture and, rarely, massive allograft resorption. Although bone allografting is a successful procedure, future improved technology to regenerate bone includes the use of adjunctive growth factors, cell based and regional gene therapies. Ultimately tissue engineering techniques may be the most useful approach to regenerate bone.

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Authors and Affiliations

  1. Department of Orthopaedics, Case Medical Center, Cleveland, OH

    Victor M. Goldberg

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  1. Victor M. Goldberg
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Editors and Affiliations

  1. Department of Bioengineering, University of Illinois at Chicago, Chicago, IL, USA

    William S. Pietrzak Ph.D.

  2. Biomet, Inc., Warsaw, IN, USA

    William S. Pietrzak Ph.D.

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© 2008 Humana Press, a part of Springer Science+Business Media, LLC

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Goldberg, V.M. (2008). Biology of Bone Allograft and Clinical Application. In: Pietrzak, W.S. (eds) Musculoskeletal Tissue Regeneration. Orthopedic Biology and Medicine. Humana Press. https://doi.org/10.1007/978-1-59745-239-7_5

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  • DOI: https://doi.org/10.1007/978-1-59745-239-7_5

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-909-3

  • Online ISBN: 978-1-59745-239-7

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