The use of irradiated allograft in a paediatric population: an Indian experience

Abstract

Lyophilised, irradiated bone allografts available for the first time in the country from the Tata Memorial Hospital Tissue Bank were used in 30 paediatric patients from January 2001 to August 2004. They included 20 patients of scoliosis of various origin and ten with assorted orthopaedic conditions including one congenital kyphosis, two Pott's spine, one Perthes disease, one developmental dysplasia of the hip (DDH), one infective non-union, one fibrous dysplasia and three with bone defects either due to trauma, a cyst or removal of hardware. Morsellised allograft was used in 28 patients. In those cases of scoliosis in which ribs were resected out during costectomy, the morsellised allograft was mixed with morsellised rib autograft. Non-morsellised femoral head grafts were used in two patients, one a case of varus open derotation osteotomy in Perthes disease and the other an acetabuloplasty in DDH. Patients were followed at intervals of 8-12 weeks and radiological evaluation was done periodically. The follow up period ranged from 1 to 4 years post surgery. All patients with scoliosis showed excellent union at the grafting site with non-progression of curve and no signs of loosening at implant site. The two patients, in whom non-morsellised femoral head grafts were used, both showed incorporation of the graft with good fusion within a 4 month period. None of the patient had infection, non-union, pseudoarthrosis, fracture at the graft site, or any other complication.

Massive allograft of the tibia for a child with McCune–Albright syndrome: case presentation and surgical intervention

“…These are used as scaffolds for regrowth of healthy bone with or without vascularized grafts or metal implants augmentation. The use of a massive allograft for replacement of involved bone has only rarely been described in FD [6,7]. Massive bone allografts in pediatric skeletal reconstruction is further complicated by the need to protect growth plates and to refrain from using stiff intramedullary nails.…”

The impact of the International Atomic Energy Agency (IAEA) program on radiation and tissue banking in India

“…Morsellised and strut bone allografts have found use in reconstructing skeletal defects, fusing joints, augmenting fracture healing and joint reconstruction procedures Lobo Gajiwala et al 2003c;Johari et al 2007). At TMH, the availability of allografts has enabled a number of innovative surgeries for limb salvage following ablative surgery in tumour patients (Agarwal et al 2007a, b).…”

Enhanced Differentiation of Human Embryonic Stem Cells on Extracellular Matrix-Containing Osteomimetic Scaffolds for Bone Tissue Engineering

“…[1][2][3] Current treatment methods for critical-sized defects (CSDs) include (i) autografts, where the patient's own bone tissue is removed from one area and placed in the site of deficiency, (ii) allografts, where bone from a cadaver is used to replace the damaged tissue, (iii) and synthetic grafts, where manufactured materials are implanted and used to treat the CSD. [4][5][6] Autografts are considered the gold standard in clinical applications because of their osteoconductivity, osteoinductivity, and osteogenecity, however, a secondary surgery is required for implementation. There is also a risk of disease transfer, rejection by the host, and large bone defects cannot be treated by autografts.…”