Processed versus fresh frozen bone for impaction bone grafting in revision hip arthroplasty

Board, T; Brunskill, Susan J; Dorée, Carolyn; Hyde, Chris; Kay, PR; Meek, R.M.D.; Webster, Robert J.; Galea, George

doi:10.1002/14651858.cd006351

Cited by 3 publications

(5 citation statements)

References 23 publications

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“…Authorized tissue banks follow strict international guidelines for tissue harvesting and storing in order to ensure a more effective and safe application, hence making the risk of antigenicity and primary infections acceptably low . Various types of processing of allografts have been described and the FFBs have biomechanical advantages compared with freeze‐dried and demineralized allografts . Therefore, FFB possesses necessary strength and rigidity to allow stable fixation in the recipient area .…”

Section: Introductionmentioning

confidence: 99%

“…[35][36][37] Various types of processing of allografts have been described and the FFBs have biomechanical advantages compared with freeze-dried and demineralized allografts. 38,39 Therefore, FFB possesses necessary strength and rigidity to allow stable fixation in the recipient area. 40 A systematic review 41 included nine studies, [42][43][44][45][46][47][48][49][50] but excluded the ones that examined freshfrozen allografts.…”

Section: Introductionmentioning

confidence: 99%

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Horizontal Resorption of Fresh‐Frozen Corticocancellous Bone Blocks in the Reconstruction of the Atrophic Maxilla at 5 Months

Pereira

Messias

Dias

et al. 2014

Clin Implant Dent Rel Res

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BackgroundReliable implant-supported rehabilitation of an alveolar ridge needs sufficient volume of bone. In order to achieve a prosthetic-driven positioning, bone graft techniques may be required.PurposeThis prospective cohort study aims to clinically evaluate the amount of resorption of corticocancellous fresh-frozen allografts bone blocks used in the reconstruction of the severe atrophic maxilla.Materials and MethodsTwenty-two partial and totally edentulous patients underwent bone augmentation procedures with fresh-frozen allogenous blocks from the iliac crest under local anesthesia. Implants were inserted into the grafted sites after a healing period of 5 months. Final fixed prosthesis was delivered ± 4 months later. Ridge width analysis and measurements were performed with a caliper before and after grafting and at implant insertion. Bone biopsies were performed in 16 patients.ResultsA total of 98 onlay block allografts were used in 22 patients with an initial mean alveolar ridge width of 3.41 ± 1.36 mm. Early exposure of blocks was observed in four situations and one of these completely resorbed. Mean horizontal bone gain was 3.63 ± 1.28 mm (p < .01). Mean buccal bone resorption between allograph placement and the reopening stage was 0.49 ± 0.54 mm, meaning approximately 7.1% (95% confidence interval: [5.6%, 8.6%]) of total ridge width loss during the integration period. One hundred thirty dental implants were placed with good primary stability (≥ 30 Ncm). Four implants presented early failure before the prosthetic delivery (96.7% implant survival). All patients were successfully rehabilitated. Histomorphometric analysis revealed 20.9 ± 5.8% of vital bone in close contact to the remaining grafted bone. A positive strong correlation (adjusted R2 = 0.44, p = .003) was found between healing time and vital bone percentage.ConclusionsAugmentation procedures performed using fresh-frozen allografts from the iliac crest are a suitable alternative in the reconstruction of the atrophic maxilla with low resorption rate at 5 months, allowing proper stability of dental implants followed by fixed prosthetic rehabilitation.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Horizontal Resorption of Fresh‐Frozen Corticocancellous Bone Blocks in the Reconstruction of the Atrophic Maxilla at 5 Months

Pereira

Messias

Dias

et al. 2014

Clin Implant Dent Rel Res

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“…Both massive bone allografts and morselized bone pieces, as filling material, are used in orthopedic surgery [ 10 , 11 ]. Bone grafts are required in about 15% of all reconstructive operations.…”

Section: Discussionmentioning

confidence: 99%

The Pyrolytic Profile of Lyophilized and Deep-Frozen Compact Part of the Human Bone

Lodowska

Wolny

Kurkiewicz

et al. 2012

The Scientific World Journal

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Background. Bone grafts are used in the treatment of nonunion of fractures, bone tumors and in arthroplasty. Tissues preserved by lyophilization or deep freezing are used as implants nowadays. Lyophilized grafts are utilized in the therapy of birth defects and bone benign tumors, while deep-frozen ones are applied in orthopedics. The aim of the study was to compare the pyrolytic pattern, as an indirect means of the analysis of organic composition of deep-frozen and lyophilized compact part of the human bone. Methods. Samples of preserved bone tissue were subjected to thermolysis and tetrahydroammonium-hydroxide- (TMAH-) associated thermochemolysis coupled with gas chromatography and mass spectrometry (Py-GC/MS). Results. Derivatives of benzene, pyridine, pyrrole, phenol, sulfur compounds, nitriles, saturated and unsaturated aliphatic hydrocarbons, and fatty acids (C12–C20) were identified in the pyrolytic pattern. The pyrolyzates were the most abundant in derivatives of pyrrole and nitriles originated from proteins. The predominant product in pyrolytic pattern of the investigated bone was pyrrolo[1,2-α]piperazine-3,6-dione derived from collagen. The content of this compound significantly differentiated the lyophilized graft from the deep-frozen one. Oleic and palmitic acid were predominant among fatty acids of the investigated samples. The deep-frozen implants were characterized by higher percentage of long-chain fatty acids than lyophilized grafts.

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“…Currently, there are no randomised controlled trials comparing fresh frozen allograft with processed bone graft, despite fresh frozen allograft being associated with the best long term results in impaction grafting (Board et al 2009;Schreurs et al 2005). Although the adverse impact to structural and biological characteristics is minimised, risks of infection remain due to retention of medullary contents.…”

Section: Discussionmentioning

confidence: 99%

“…Impaction grafting is most commonly performed using fresh frozen femoral head allograft, thawed at the time of surgery and milled to the required size (Board et al 2009). The relative merits of a particular allograft type may be considered on the basis of proven efficacy with respect to bone formation and host bone incorporation as well as minimising risks of possible disease transmission from the donor to the recipient.…”

Section: Introductionmentioning

confidence: 99%

Intra-operative washing of morcellised bone allograft with pulse lavage: how effective is it in reducing blood and marrow content?

et al. 2011

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The use of unprocessed bone carries a risk of transmission of blood borne diseases. Although models of infectivity are unproven, a theoretical risk of transmission of variant Creutzfeld-Jakob Disease, a human prion disease, exists as probable blood borne transmission has been reported in three cases. The aim of our study was to determine the effectiveness of standard operating theatre pulse lavage in removing protein, fat and double stranded Deoxyribonucleic acid (dsDNA) from morcellised bone allograft. Twelve donated femoral heads were divided into halves and milled into bone chips. One half of the bone chips were washed with pulse lavage, whereas, the other half acted as control. In order to determine the amount of protein, fat and dsDNA present in the washed and unwashed samples, a validated multistep washing protocol was used. Using the validated technique, simple intra-operative washing of morcellised unprocessed bone allograft removed a significant amount of the protein (70.5%, range: 39.5-85%), fat (95.2%, range: 87.8-98.8%) and DNA (68.4%, range: 31.4-93.1%) content. Intra-operative washing of morcellised bone allograft with pulse lavage may thereby reduce the theoretical risk of prion and other blood borne disease transmission. Combined with the known improved mechanical characteristics of washed allograft, we would recommend pulse lavage as a routine part of bone allograft preparation.

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Processed versus fresh frozen bone for impaction bone grafting in revision hip arthroplasty

Cited by 3 publications

References 23 publications

Horizontal Resorption of Fresh‐Frozen Corticocancellous Bone Blocks in the Reconstruction of the Atrophic Maxilla at 5 Months

Horizontal Resorption of Fresh‐Frozen Corticocancellous Bone Blocks in the Reconstruction of the Atrophic Maxilla at 5 Months

The Pyrolytic Profile of Lyophilized and Deep-Frozen Compact Part of the Human Bone

Intra-operative washing of morcellised bone allograft with pulse lavage: how effective is it in reducing blood and marrow content?

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