Published: Jan 2003
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THE IDEAL BONE GRAFT SUBSTITUTE should contain all three prerequisites for new bone formation. These are osteoinductive factors that induce bone formation, osteoconductive matrix to provide both physical support and direction to the reparative process, and osteogenic stem cells that are capable of differentiating towards bone forming cells. No allograft system contains all three of these factors. Allograft osteogenic cells do not survive transplantation and the osteoinductive capacity of many allograft systems is variable. When one or more of these vital ingredients is absent the host environment must be relied upon to produce the missing factor. Fusion and union rates using autograft remains the gold standard in clinical practice and the results of any bone graft substitute must be compared to autograft. Autograft has major disadvantages that are well documented and include donor site morbidity, increased operative time and blood loss, and often, most importantly, limited quantity . Allograft bone is a widely used alternative; however, its inherent properties are dependent on many factors that affect its efficacy. To make those who use allograft bone products aware of these factors is the purpose of this article. Two categories of allograft exist, mineralized and demineralized; each will be considered in turn.
Weill-Cornell University Medical, College, Hospital for Special Surgery, New York, NY
Chief, Weill-Cornell University Medical, College, Hospital for Special Surgery, New York, NY
Paper ID: MONO10058M