Outcomes of cryopreserved allograft in long bones fractures and nonunions
Article Sidebar
Published:
Jun 11, 2015
Keywords:
Bone allograft, Bone defect, Nonunion, Open fractures
Main Article Content
Abstract
BackgroundThe aim of this study was to evaluate the indications and incorporation of cryopreserved allograft in long bone fractures and nonunions.MethodsRetrospective study of 20 patients treated between 2005 and 2011, with 7 fractures and 14 long bones nonunions in which cryopreserved allograft bone was used (one patient had bilateral femoral involvement), associated with autograft in 11 cases. Average age 45.2 years (range 19 to 74). Ten women and ten men. Bone defects were classified according to whether they were circumferential or not.ResultsBony union after using morcellized allograft was achieved in 14 cases, after an average of 8 months (range 4 to 18), among the remaining 7 cases union was achieved after revision surgery in 5 cases, another case did not achieve consolidation, and an amputation was performed in another patient.ConclusionsBone autograft remains the gold standard in bone defect reconstructions. Using new extraction systems for autografts, such as reamed irrigation/aspiration (RIA, Synthes) has made the use of allograft in fractures infrequent. In our patients with multiple surgeries, bone defects or severe psychiatric disorders, the use of isolated cryopreserved allograft or associated with bone autograft obtained good results (18 cases with consolidation), although 5 patients required revision surgeries.
Downloads
Download data is not yet available.
Metrics
Metrics Loading ...
Article Details
How to Cite
Fernández Savoy, I. A., Salcedo Zunino, L., Malvarez, A., Pioli, I., Allende, B. L., & Allende, C. A. (2015). Outcomes of cryopreserved allograft in long bones fractures and nonunions. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 80(2), 85-93. https://doi.org/10.15417/320
Issue
Section
Clinical Research
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Manuscript acceptance by the Journal implies the simultaneous non-submission to any other journal or publishing house. The RAAOT is under the Licencia Creative Commnos Atribución-NoComercial-Compartir Obras Derivadas Igual 4.0 Internacional (CC-BY-NC.SA 4.0) (http://creativecommons.org/licences/by-nc-sa/4.0/deed.es). Articles can be shared, copied, distributed, modified, altered, transformed into a derivative work, executed and publicly communicated, provided a) the authors and the original publication (Journal, Publisher and URL) are mentioned, b) they are not used for commercial purposes, c) the same terms of the license are maintained.
In the event that the manuscript is approved for its next publication, the authors retain the copyright and will assign to the journal the rights of publication, edition, reproduction, distribution, exhibition and communication at a national and international level in the different databases. data, repositories and portals.
It is hereby stated that the mentioned manuscript has not been published and that it is not being printed in any other national or foreign journal.
The authors hereby accept the necessary modifications, suggested by the reviewers, in order to adapt the manuscript to the style and publication rules of this Journal.
References
1. An HS, Lynch K, Toth J. Prospective comparison of autograft vs. allograft for adult posterolateral lumbar spine fusion:
differences among freeze-dried, frozen, and mixed grafts. J Spinal Disord 1995;8(2):131-5.
2. Winkler H. Rationale for one stage exchange of infected hip replacement using uncemented implants and antibiotic impregnated
bone graft. Int J Med Sci 2009;6(5):247-52.
3. López Millán L, Aponte Tinao L, Farfalli G, Ayerza M, Muscolo DL. Reconstrucción de defectos segmentarios del fémur con
aloinjerto óseo intercalar. Rev Asoc Argent Ortop Traumatol 2011;76:309-15.
4. Ateschrang A, Ochs BG, Lüdemann M, Weise K, Albrecht D. Fibula and tibia fusion with cancellous allograft vitalised with
autologous bone marrow: first results for infected tibial non-union. Arch Orthop Trauma Surg 2009;129(1):97-104.
5. Masquelet AC, Fitoussi F, Begue T, Muller GP. Reconstruction of the long bones by the induced membrane and spongy
autograft. Ann Chir Plast Esthet 2000;45:346-53.
6. Myeroff C, Archdeacon M. Autogenous bone graft: donor sites and techniques. J Bone Joint Surg Am 2011;93(23):2227-36.
7. Sasso RC, LeHuec JC, Shaffrey C; Spine Interbody Research Group. Iliac crest bone graft donor site pain after anterior
lumbar interbody fusion: a prospective patient satisfaction outcome assessment. J Spinal Disord Tech 2005;18:77-81.
8. McLaren AC, Miniaci A. In vivo study to determine the efficacy of cancellous bone graft as a delivery vehicle for antibiotics.
Trans Soc Biomat 1986;12:1.
9. Gray JC, Elves MW. Osteogenesis in bone grafts after short-term storage and topical antibiotic treatment. An experimental study
in rats. J Bone Joint Surg Br 1981;63:441-5.
10. Aurori BF, Weierman RJ, Lowell HA, Nadel CL, Parsons JR. Pseudarthrosis after spinal fusion for scoliosis. A comparison of
autogeneic and allogeneic bone grafts. Clin Orthop Relat Res 1985;199:153-8.
11. Lindsey RW, Probe R, Miclau T, Alexander JW, Perren SM. The effects of antibiotic-impregnated autogeneic cancellous bone
graft on bone healing. Clin Orthop Relat Res 1993;291:303-12.
12. Aponte-Tinao LA, Ayerza MA, Muscolo DL, Farfalli GL. Allograft reconstruction for the treatment of musculoskeletal tumors
of the upper extremity. Sarcoma 2013; ID 925413, 6 páginas.
13. Allende C. Cement spacers with antibiotics for the treatment of posttraumatic infected nonunion and bone defects of the upper
extremity. Tech Hand Up Extrem Surg 2010;14(4):241-7.
14. Canale ST. Campbell Cirugía Ortopédica, 10th ed. Tennessee: Edit. Mosby; 2004;3:1692.
15. Aspenberg P, Astrand J. Bone allografts pretreated with a biphosphonate are not resorbed. Acta Orthop Scand 2002;73(1):20-3.
16. Cid Causteulani A. Enriquecimiento de injerto autólogo con concentrado de factores de crecimiento. Rev Asoc Argent Ortop
Traumatol 2007;72:373-81.
17. Hollenbeck ST, Woo S, BS, Ong S, Fitch RD, Erdmann D, Levin LS. The combined use of the Ilizarov method and
microsurgical techniques for limb salvage. Ann Plast Surg 2009;62:486-91.
18. Lowenberg DW, Feibel RJ, Louie KW, Eshima L. Combined muscle flap and Ilizarov reconstruction for bone and soft tissue
defects. Clin Orthop Relat Res 1996;322:37-51.
19. Giannoudis PV, Pountos I, Morley J, Perry S, Tarkin HL, Pape HC. Growth factor release following femoral nailing. Bone
2008;42:751-7.
20. Belthur MV, Conway JD, Jindal G, Ranade A, Herzenberg JE. Bone graft harvest using a new intramedullary system. Clin
Ortop Relat Res 2008;466:2973-80.
21. Scharfenberger AV, Weber TG. Reamer irrigator aspirator (RIA) for bone graft harvest: applications for grafting large segmental
defects in the tibia and femur. J Bone Joint Surg Br 2008;90:(Suppl I):95
differences among freeze-dried, frozen, and mixed grafts. J Spinal Disord 1995;8(2):131-5.
2. Winkler H. Rationale for one stage exchange of infected hip replacement using uncemented implants and antibiotic impregnated
bone graft. Int J Med Sci 2009;6(5):247-52.
3. López Millán L, Aponte Tinao L, Farfalli G, Ayerza M, Muscolo DL. Reconstrucción de defectos segmentarios del fémur con
aloinjerto óseo intercalar. Rev Asoc Argent Ortop Traumatol 2011;76:309-15.
4. Ateschrang A, Ochs BG, Lüdemann M, Weise K, Albrecht D. Fibula and tibia fusion with cancellous allograft vitalised with
autologous bone marrow: first results for infected tibial non-union. Arch Orthop Trauma Surg 2009;129(1):97-104.
5. Masquelet AC, Fitoussi F, Begue T, Muller GP. Reconstruction of the long bones by the induced membrane and spongy
autograft. Ann Chir Plast Esthet 2000;45:346-53.
6. Myeroff C, Archdeacon M. Autogenous bone graft: donor sites and techniques. J Bone Joint Surg Am 2011;93(23):2227-36.
7. Sasso RC, LeHuec JC, Shaffrey C; Spine Interbody Research Group. Iliac crest bone graft donor site pain after anterior
lumbar interbody fusion: a prospective patient satisfaction outcome assessment. J Spinal Disord Tech 2005;18:77-81.
8. McLaren AC, Miniaci A. In vivo study to determine the efficacy of cancellous bone graft as a delivery vehicle for antibiotics.
Trans Soc Biomat 1986;12:1.
9. Gray JC, Elves MW. Osteogenesis in bone grafts after short-term storage and topical antibiotic treatment. An experimental study
in rats. J Bone Joint Surg Br 1981;63:441-5.
10. Aurori BF, Weierman RJ, Lowell HA, Nadel CL, Parsons JR. Pseudarthrosis after spinal fusion for scoliosis. A comparison of
autogeneic and allogeneic bone grafts. Clin Orthop Relat Res 1985;199:153-8.
11. Lindsey RW, Probe R, Miclau T, Alexander JW, Perren SM. The effects of antibiotic-impregnated autogeneic cancellous bone
graft on bone healing. Clin Orthop Relat Res 1993;291:303-12.
12. Aponte-Tinao LA, Ayerza MA, Muscolo DL, Farfalli GL. Allograft reconstruction for the treatment of musculoskeletal tumors
of the upper extremity. Sarcoma 2013; ID 925413, 6 páginas.
13. Allende C. Cement spacers with antibiotics for the treatment of posttraumatic infected nonunion and bone defects of the upper
extremity. Tech Hand Up Extrem Surg 2010;14(4):241-7.
14. Canale ST. Campbell Cirugía Ortopédica, 10th ed. Tennessee: Edit. Mosby; 2004;3:1692.
15. Aspenberg P, Astrand J. Bone allografts pretreated with a biphosphonate are not resorbed. Acta Orthop Scand 2002;73(1):20-3.
16. Cid Causteulani A. Enriquecimiento de injerto autólogo con concentrado de factores de crecimiento. Rev Asoc Argent Ortop
Traumatol 2007;72:373-81.
17. Hollenbeck ST, Woo S, BS, Ong S, Fitch RD, Erdmann D, Levin LS. The combined use of the Ilizarov method and
microsurgical techniques for limb salvage. Ann Plast Surg 2009;62:486-91.
18. Lowenberg DW, Feibel RJ, Louie KW, Eshima L. Combined muscle flap and Ilizarov reconstruction for bone and soft tissue
defects. Clin Orthop Relat Res 1996;322:37-51.
19. Giannoudis PV, Pountos I, Morley J, Perry S, Tarkin HL, Pape HC. Growth factor release following femoral nailing. Bone
2008;42:751-7.
20. Belthur MV, Conway JD, Jindal G, Ranade A, Herzenberg JE. Bone graft harvest using a new intramedullary system. Clin
Ortop Relat Res 2008;466:2973-80.
21. Scharfenberger AV, Weber TG. Reamer irrigator aspirator (RIA) for bone graft harvest: applications for grafting large segmental
defects in the tibia and femur. J Bone Joint Surg Br 2008;90:(Suppl I):95