Bone and Connective Tissue
| Autor: | David M. Smith, Judith E. Woll |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
medicine.medical_specialty
Bone Transplantation business.industry Biochemistry (medical) Clinical Biochemistry Nonunion Connective tissue Soft tissue Tissue Banks Bone healing medicine.disease Iliac crest Bone and Bones Surgery surgical procedures operative medicine.anatomical_structure Connective Tissue Tissue bank Orthopedic surgery Humans Medicine Implant business |
| Zdroj: | Clinics in Laboratory Medicine. 25:499-518 |
| ISSN: | 0272-2712 |
| DOI: | 10.1016/j.cll.2005.06.003 |
| Popis: | Bone grafts are an essential component of many orthopedic, sports medicine, neurosurgical, faciomaxillary, and oral surgeries. Bone grafts are used for a variety of purposes: to fill bone cysts, for spinal (cervical and lumbar) fusion, facial and limb reconstruction after resection of tumors, hip and knee revision surgery, and for nonunion fractures [1]. The traditional ‘‘gold standard’’ for bone repair has been fresh autologous iliac crest bone. However, the complications of using autologous tissue, such as lack of adequate bone volume and morbidity associated with the autograft donor site, have made cadaveric allogeneic bone a preferred alternative for many procedures. Allogeneic bone from cadaver donors has been used successfully for many procedures, with over 1,000,000 allografts transplanted in 2004 in the United States alone. Currently, musculoskeletal allografts provide the best solution for many surgical procedures where an autograft is not available, to reduce donor morbidity and hospital stay, or as a supplement when an ample supply of autograft tissue is not available. Man-made implant devices are readily available and produced with remarkable precision, but incorporation into the skeleton and the attachment of soft tissues remains a problem. Advantages of allogeneic bone include long-term storage, wide availability, and an adequate inventory of grafts with differing specificities and sizes. The most common long-term storage methods are freezing and freeze drying, but both render the cellular components in the grafts nonviable. When cellular viability is required, allografts may be used fresh or cryopreserved. The sequence of histologic events in the incorporation of bone grafts has been well described and summarized [2]. For a massive, nonvascularized segmental allograft, the initial event is the formation of a hematoma, which contains platelet-derived growth factors and other growth factors. A local inflammatory response develops and peaks between the second and third |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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