Clinical application of morselized allogeneic bone processed by lyophilization and radiation
- VernacularTitle:同种异体冻干小块骨的临床应用
- Author:
Zhiqiang WANG
;
Qi WANG
;
Lixin SU
- Publication Type:Journal Article
- Keywords:
Bone transplantation;
Transplantation, homologous;
Bone defect
- From:
Chinese Journal of Orthopaedics
1996;0(10):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical result, complication and influential factors of lyophilized and radiation-sterilized morselized allogeneic bone. Methods Between December 1995 and December 2000, 778 cases with implantation of bone allograft were performed. There were 188 females and 590 males with an average age of 37.2 years (range, 6-76 years). The lyophilized morselized allogeneic bone was processed according to American Association of Tissue Bank (AATB) standards and was sterilized by radiation. The bone allograft was rehydrated in fresh blood or in physiologic saline before implantation. The morselized allograft was used to fill defects attributable to various causes such as 84 bone tumors (10.8%), 551 fractures (70.8%), 143 joint fusions (18.4%). After implantation of the bone allograft, drainage was carried out for 2~3 days and antibiotics were used to prevent infection. The average amount of the allograft implanted was 24 g (range, 4-64 g). Results All patients were followed up clinically and radiographically. The minimum length of follow-up was 3 years with an average follow-up period of 59.7 months (range, 36-96 months), 722 allograft unions occurred at a mean of 4.5 months postoperatively (range, 3-8 months). There were 137 complications, included 44 of wound effusion (5.65%), 29 of delayed wound healing (3.72%), 2 of profuse liquid accumulation (0.26%), 43 of fracture non-union (5.52%), 4 of tumor recurrence (0.51%), 9 of fusion failure (1.15%) and 6 of fracture (0.77%). Estimated by the combined Mankin and Komender standards, 688 (88.44%) patients were satisfied with their outcomes while the other 90 (11.56%) patients were dissatisfied. Conclusion The lyophilized and radiation-sterilized morselized allograft is of good tissue compatibility and able to promote bone formation, it can be considered as a convenient, safe, and available material for bone transplantation. The important factors affecting allograft healing are the mechanical stability in the recipient region, local blood supply for the site of grafting and the surgical technology. The major complications of allograft are late infection and re-fracture.
