EDU: Surgery - Bone Grafts

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Definition:

A bone graft is surgery to place new bone into spaces around a broken bone or

in between holes and defects in bone. The new bone can be taken from the

patient's own healthy bone (this is called an autograft) or from frozen, donated

bone (allograft). Alternative Names:

Autograft; Allograft

Description:

An cut is made over the bone defect and the bone graft is shaped and inserted

into and around the defect. The graft is held in place with pins, plates, or

screws. The incisions are stitched closed. A splint or cast is usually used to

prevent injury or movement while healing.

Indications:

Bone grafts are used to:

Repair broken bones (fractures) that have bone loss

Repair injured bone that has not healed

Fuse joints to prevent movement

http://drdean.healthcentral.com/ency/408/002963.html

Bone Graph Substitutes for the Promotion of Spinal Arthrodesis:

http://www.medscape.com/viewarticle/405701_print

In the prototypical method for inducing spinal fusion, autologous bone graft

is harvested from the iliac crest or local bone removed during the spinal

decompression. Although autologous bone remains the " gold standard " for

stimulating bone repair and regeneration, modern molecular biology and

bioengineering techniques have produced unique materials that have potent

osteogenic activities. Recombinant human osteogenic growth factors, such as bone

morphogenetic proteins, transforming growth factor, and platelet-derived growth

factor are now produced in highly concentrated and pure forms and have been

shown to be extremely potent bone-inducing agents when delivered in vivo in

rats, dogs, primates, and humans. The delivery of pluripotent mesenchymal stem

cells (MSCs) to regions requiring bone formation is also compelling, and it has

been shown to be successful in inducing osteogenesis in numerous preclinical

studies in rats and dogs. Finally, the identification of biological

and nonbiological scaffolding materials is a crucial component of future bone

graft substitutes, not only as a delivery vehicle for bone growth factors and

MSCs but also as an osteoconductive matrix to stimulate bone deposition

directly. In this paper, the currently available bone graft substitutes will be

reviewed and the authors will discuss the novel therapeutic approaches that are

currently being developed for use in the clinical setting.

A Closer Look At Bone Graph Substitutes / Understanding The Physiological

Processes Of Bone Healing

In order to appreciate the useful features of bone graft substitutes, it is

important to review some of the physiological processes underpinning bone

healing in the presence of a bone graft. Bone graft incorporation occurs via a

process referred to as “creeping substitution,” whereby the graft material is

actually replaced by new bone formation. This desirable and complex event

depends upon three underlying processes: osteoconduction, osteoinduction and

osteogenesis. http://www.podiatrytoday.com/article/3466

Bone fracture repairDefinition:

Bone fracture repairs are surgical procedures to realign and stabilize broken

bones (fractures) with plates, nails, screws, or pins. Bone grafts may be used

to allow for proper healing or to speed the healing process.

http://www.healthcentral.com/ency/408/002966.html

Other helpful information.

Inflammatory Arthtitis of the Hip - mentions bone grafts for repair of

Osteonecrosis bones in patients with SLE and RA

http://orthoinfo.aaos.org/fact/thr_report_pows.cfm?Thread_ID=288 & mailname=Jonath\

an+E+Fow%2C+MD & patientpage=patient_info.cfm & webid=3179

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