Experiences With Boiled Cadaveric Cancellous Bone for Fractures of Long Bones

Williams, Grant

doi:10.1302/0301-620x.46b3.398

Cited by 21 publications

(2 citation statements)

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“…The possibility that autoclaving may increase the risk of bone resorption has been of concern to many [1,7,24,34,56]. Experimental studies and some clinical observations warn that osteo-inductive properties Fig.…”

Section: Discussionmentioning

confidence: 99%

Cranioplasty with autogenous autoclaved calvarial bone flap in the cases of tumoural invasion

et al. 1997

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When a bone flap is raised in the course of a craniotomy, the ideal is to replace it at the end of the procedure. When it is invaded by tumoural cells, it cannot be replaced due to the risk of tumoural recurrence. In these cases we have autoclaved the bone flap to be able to replace it with no fear of tumoural recurrence. Between October 1989 and October 1995 sixty-two patients required autoclaving of the bone flap in the course of a craniotomy due to tumoural invasion (thirty-five meningiomas, sixteen bone tumours, five metastases, and eight scalp tumours). The infiltrated bone flaps were removed, cleaned, autoclaved for 20 minutes at 134 degrees C and 1 kg/cm2 and re-implanted. Patients were followed-up for 10 to 58 months (average 41 months). At every follow-up visit skull x-ray studies, clinical examination, and photographs were done. When needed a CT scan was performed to assess the thickness of the bone flap. On follow-up roentgenograms partial resorption was observed in twelve cases (19.3%). CT scan studies showed loss of thickness in another thirty-five cases (56.4%). Meanwhile the external aspect remained unchanged. In six cases (3.2%) biopsies of the bone flaps were taken at a second surgical procedure. They showed newly formed bone partly re-populated by osteocytes but retaining areas of sequestered bone. We conclude that autoclaved bone, if replaced with direct contact with living bone, it is gradually repopulated with osteocytes. Cranial vault autoclaved autologous bone flap is a good alternative when the original bone flap is invaded but not destroyed by tumoural cells.

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Section: Discussionmentioning

confidence: 99%

Cranioplasty with autogenous autoclaved calvarial bone flap in the cases of tumoural invasion

et al. 1997

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“…Although autoclaved bone is sterile and less antigenic than untreated bone [21,28,63,111,134,197], it is biologically inactive. Urist [174,180] stated that this was due to the denaturation of osteoinductive effective proteins.…”

Section: Sterilization Of Bonementioning

confidence: 99%

Bone transplantation

Schweiberer¹,

St�tzle

Mandelkow

1989

Arch Orthop Trauma Surg

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According to one principle of surgery, the transplantation of vital tissue is the best method of reconstructing a defect. Because of absent immunologic reactions, high osteogenic potency, and preserved stability, transplantation of autogenous bone shows the best results. Necrosis of transplanted bone, leading inevitably to absorption and remodeling of the graft, can be avoided if microsurgically vascularized autogenous bone segments are transferred. Disadvantages are the low availability and the necessity of additional operations. As an alternative, deep-frozen allogeneic bone is used. However, this kind of bone shows delayed incorporation based on cellular and humoral immune reactions, and it is also installed into the host bed after overcoming the immune barrier. The risk of microbiological contamination or transmission of unrecognized germs such as HIV is a cause of great expense in bone banking techniques. If one succeeds in reducing (a) the immunologic defense reaction and (b) the risk of infection by sterilization or disinfection without damaging the osteoinductive proteins of bone matrix, the rate of complications can be lowered. Demineralized bone matrix can be used if biomechanical stability is not required. Its ability to induce osteogenesis without a major immune reaction or the risk of transmitting diseases justifies its clinical application. Further intensive research in these areas is unavoidable.

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Cold stored femoral vessels as microvascular allografts: A preliminary study

et al. 1994

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Cold stored femoral arteries or veins have been reinserted successfully as autografts into rabbits. The present study examines whether grafting with cold stored vascular allografts is equally successful. Rabbit femoral arteries and veins were stored at 4 degrees C for 4 weeks before insertion as allografts into unrelated animals. Three weeks after insertion into the femoral artery all venous allografts and 80% of arterial allografts were patent, but patency of both graft types declined over the next few weeks. A small number of cold stored venous allografts when inserted into the femoral vein occluded within 3 weeks. No histological evidence of rejection was apparent. The findings suggest that cold stored vascular allografts could be used successfully as an arterial "prosthesis" to support free flaps where relatively short term patency is required until the flap can establish sufficient peripheral inset to survive in its own right. This technique could be applied when autologous veins are not available or not justified.

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Experiences With Boiled Cadaveric Cancellous Bone for Fractures of Long Bones

Abstract: Studies on Transference of Bone. II. Vascularization of Autologous and Homologous Implants of Cortical Bone in Rats.

Cited by 21 publications

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Cranioplasty with autogenous autoclaved calvarial bone flap in the cases of tumoural invasion

Cranioplasty with autogenous autoclaved calvarial bone flap in the cases of tumoural invasion

Bone transplantation

Cold stored femoral vessels as microvascular allografts: A preliminary study

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