Fate of Vascularized and Nonvascularized Autografts

Reconstruction with a free vascularized fibular graft for malignant bone tumor

“…Experiments suggest that vascularized bone grafts have a capacity to respond to mechanical stress (Shaffer et al 1985). This was especially well demonstrated in Case 2, with dramatic thickening of the graft during weight bearing (Figure 2), and in Case 7 with highly increased isotope uptake and thickening of the graft shortly after removal of the external fixation (Figure 4).…”

Bone formation by three-dimensional stromal osteoblast culture in biodegradable polymer scaffolds

“…−6 mol/cell/min on Days 7 and 28, respectively; and they had a cell density that increased to 18.7 × 10 5 cells/cm 2 by Day 56. For the same constructs, the mineralized matrix reached a maximum penetration depth of 240 m from the top surface of the foam and a value of 0.083 mm for mineralized tissue volume per unit of cross sectional area.…”

Free vascularized bone graft in spinal surgery: indications and outcome in eight cases

“…A nonvascularized cortical strut graft, however, relies for fusion on creeping substitution that may progress for as long as 2 years postoperatively. During this period the grafted bone is weak and can fracture and there is a risk of nonunion [2,5,11,35]. This may result in deterioration of a deformity or even dislodgment of the graft [5,20,26,29,43].…”

“…The rib, however, is mechanically not always sufficient; therefore, a fibular graft is most often used to stabilize a spinal deformity or defect. Using a nonvascularized strut graft, the graft loses its strength due to the process of creeping substitution, which results in a higher risk of fatigue fracture and the risk of non-union [11,35]. In this respect, vascularized bone grafts may overcome some of these problems: they show faster ingrowth in the adjoining bone, minimize the extent of creeping substitution, show normal remodeling and tend to resist higher biomechanical loads [3,11,15,20].…”