A Historical Review of Common Bone Graft Materials in Foot and Ankle Surgery

Arner, Justin W.; Santrock, Robert D.

doi:10.1177/1938640013516358

Cited by 37 publications

(22 citation statements)

References 38 publications

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“…23,24 The fact that the graft must play biomechanical as well as biological roles means that simply inserting a morselized graft of any type and relying on plate and screw fixation alone is, at least theoretically, a risky endeavor. [26][27][28] Reported complications include significant (and in some cases chronic) donor-site pain, wound complications and deep-site infection, fracture, postoperative seroma/hematoma, lateral femoral cutaneous nerve injury, and muscle and abdominal content herniation among other complications 28,32,33 (Fig. The type of graft used has been shown to have an effect on the graft stability, with native graft seeming to have some advantages in this regard.…”

Section: Graftmentioning

confidence: 99%

The Treatment of Mueller-Weiss Disease: A Systematic Approach

Mayich

2016

Techniques in Foot &Amp; Ankle Surgery

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Mueller-Weiss disease (MWD), which involves dorsolateral fragmentation and collapse of the navicular, leads to functional misalignment and painful deformities. The successful treatment of MWD hinges on a detailed and through assessment of the patient to establish the modality of treatment that best suits the patient. In cases where operative management is indicated, proceeding to recreate a relatively pain-manageable (or where possible pain free), well-aligned, plantegrade foot is the goal. This can be performed technically by (1) determining as to which joints are involved/arthritic, and ensuring to address them; (2) establishing the amount of bone loss present, and planning to reconstitute this with graft material; (3) preparing the graft bed adequately and diligently to optimize the healing environment for the graft material; (4) providing a biomechanically sound treatment strategy that provides stability while the graft material heals; (5) and using orthopaedic principles while also remaining flexible. This is important because there is considerable variability in the anatomy and characteristics of MWD. Because of this, no single strategy is likely the "correct" method. Although the supporting literature remains sparse, when these principles are followed and postoperative complications can be avoided, significant improvements in function have been demonstrated and can be anticipated.Level of Evidence: Diagnostic Level 5. See Instructions for Authors for a complete description of levels of evidence.

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Section: Graftmentioning

confidence: 99%

The Treatment of Mueller-Weiss Disease: A Systematic Approach

Mayich

2016

Techniques in Foot &Amp; Ankle Surgery

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“…Autoinjertos Son el patrón oro en la sustitución ósea (1,4,7,8) . Resultan de la obtención de hueso del mismo individuo, generalmente de huesos no esenciales, como la cresta iliaca o el peroné.…”

Section: Tipos De Sustitutivos óSeosunclassified

“…Arner y Santrock (8) realizan una reciente revisión de sustitutivos óseos concluyendo que, aunque se ha demostrado que tanto el DBM como los PDGF son seguros y tienen tasas de fusión aceptables, hacen falta muchos estudios para poder recomendar su uso generalizado. Aunque hallan resultados prometedores en 2 estudios realizados con HA coralina y con DBM, no encuentran datos que apoyen el uso de sustitutivos óseos en comparación con el injerto autólogo de cresta iliaca y apuntan que existe abundante literatura de baja calidad y patrocinada por la industria farmacéutica.…”

Section: Evidencias En Pie Y Tobillo De Los Sustitutivos óSeosunclassified

“…Aunque hallan resultados prometedores en 2 estudios realizados con HA coralina y con DBM, no encuentran datos que apoyen el uso de sustitutivos óseos en comparación con el injerto autólogo de cresta iliaca y apuntan que existe abundante literatura de baja calidad y patrocinada por la industria farmacéutica. El importante coste de estos productos añadido a la ausencia de evidencia clínica de los estudios de pie y tobillo les impide realizar ninguna recomendación aparte del autoinjerto (8) .…”

Section: Evidencias En Pie Y Tobillo De Los Sustitutivos óSeosunclassified

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Sustitutivos óseos

Hernández¹

2017

MACT

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El tratamiento de los defectos óseos es un continuo reto en la traumatología (1) . Los sustitutivos óseos son materiales naturales, inorgánicos o sintéticos que pueden ser introducidos para el tratamiento de los defectos óseos como alternativa al hueso autólogo u homólogo (2) . El sustitutivo óseo ideal no debe producir respuesta inflamatoria, debe ser biocompatible, fácilmente moldeable dentro del defecto óseo, osteoconductivo, osteoinductivo y reabsorbible. Además, debe ser no termoconductor, esterilizable y fácilmente asequible a un coste razonable (3)(4)(5) . Los sustitutivos óseos se pueden clasificar en injertos óseos (autoinjertos, homoinjertos, xenoinjertos), cerámicas (hidroxiapatita -HA-, sulfato cálcico…) y factores de crecimiento (proteínas morfogenéticas óseas -BMP, bone morphogenetic proteins-, plasma rico en plaquetas -PRP-, matriz ósea desmineralizada -DBM, demineralised bone matrix-…) (2,5) (Figura 1). Están disponibles en múltiples tamaños y formas, como chips, pasta, polvo, gel… (5) (Figura 2).La osteointegración de un injerto o de otro sustitutivo óseo depende de sus propiedades osteogénicas, osteoinductoras y osteoconductoras que, todas presentes en los autoinjertos, hacen de estos los injertos óseos ideales (3)(4)(5)(6) (Figura 3):• Osteogénesis: capacidad para generar hueso desde células óseas. El injerto óseo osteogénico más utilizado es el autoinjerto, que tiene elementos celulares y factores de crecimiento.• Osteoinducción: estimulación y activación de células mesenquimales pluripotenciales del tejido circundante, que se diferencian en osteoblastos. Diferentes factores de crecimiento actúan en el proceso osteoinductivo.• Osteoconducción: capacidad de crear una nueva red vascular y un nuevo sistema haversiano en el andamiaje.

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“…This autograft bone is highly effective because it contains osteogenic cells that can directly produce bone, osteoinductive growth factors and cues that can instruct the cell fate of osteoblast progenitors and an osteoconductive matrix that allows for improved host integration of the graft. Unfortunately, these bone grafts, frequently taken from the iliac crest, necessitate a secondary surgery with its corresponding morbidities [ 7 ]. Additionally, certain diseases or conditions may require either higher quantity or quality of bone than may already exist within the patient.…”

Section: Introductionmentioning

confidence: 99%

Nanofiber-microsphere (nano-micro) matrices for bone regenerative engineering: a convergence approach toward matrix design

Nelson

Khan

Laurencin

2014

Regenerative Biomaterials

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Bone is an essential organ for health and quality of life. Due to current shortfalls in therapy for bone tissue engineering, scientists have sought the application of synthetic materials as bone graft substitutes. As a composite organic/inorganic material with significant extra cellular matrix (ECM), one way to improve bone graft substitutes may be to engineer a synthetic matrix that is influenced by the physical appearance of natural ECM networks. In this work, the authors evaluate composite, hybrid scaffolds for bone tissue engineering based on composite ceramic/polymer microsphere scaffolds with synthetic ECM-mimetic networks in their pore spaces. Using thermally induced phase separation, nanoscale fibers were deposited in the pore spaces of structurally sound microsphere-based scaffold with a density proportionate to the initial polymer concentration. Porosimetry and mechanical testing indicated no significant changes in overall pore characteristics or mechanical integrity as a result of the fiber deposition process. These scaffolds displayed adequate mechanical integrity on the scale of human trabecular bone and supported the adhesion and proliferation of cultured mouse calvarial osteoblasts. Drawing from natural cues, these scaffolds may represent a new avenue forward for advanced bone tissue engineering scaffolds.

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A Historical Review of Common Bone Graft Materials in Foot and Ankle Surgery

Cited by 37 publications

References 38 publications

The Treatment of Mueller-Weiss Disease: A Systematic Approach

The Treatment of Mueller-Weiss Disease: A Systematic Approach

Sustitutivos óseos

Nanofiber-microsphere (nano-micro) matrices for bone regenerative engineering: a convergence approach toward matrix design

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