Schliisselw6rter: Knochenbank 9 Richtlinien 9 Probleme -Anwendung Bone Banks: Guidelines -Problems -Application Abstract: Bone banks, which, due to problems concerning transmission of infectious diseases, had been shut down in many places over the last 10 years, are becoming increasingly popular all over the world again. Using different methods of virus inactivation either osteoconductivity is dramatically reduced or sterility of the transplant cannot be guaranteed. Synthetic bone replacement materials, which in addition to finally being bioresorbable also get better in terms of biomechanical stability all the time (SRS | ,,fracture grout | [Norian], alpha BSM | [Merck]) will not be able to take place neither for allogenous nor autogenous bone transplants during the next couple of years, until patient and material outcome has been evaluated over an adequate time frame. Autogenous bone transplantation therefore remains the golden standard, whereas allogenous transplantation has to be considered if cancellous bone explant sites have been exploited. In this case the guidelines of the Bundes~irztekammer from 1996 have to be applied. In the following these guidelines will be explained, occurring problems and possible solutions will be described and compared to the experiences made in other countries. Finally the use of such a bone bank will be analyzed together with a case history of polyostotic fibrous dysplasia in McCune-Albright's syndrome,
A case of surgical reconstruction of the lateral tibial plateau after impression fracture (Type 41-B3.1) of an 47-year-old female is presented. Joint reconstruction was performed by using a free patellar graft. The 16-year follow-up shows a very good functional outcome without subjective complaints. This case underlines that performing patellar autografting for surgical reconstruction of severe injury of the tibial plateau seems to be a promising alternative especially considering young patients in spite of avoiding total knee replacement.
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