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Fresh bone allograft

Charles A Baumann, John R Baumann, Chantelle C Bozynski, Aaron M Stoker, James P Stannard, James L Cook
Articular defects are a major problem with few effective treatment options. Osteochondral allograft (OCA) transplantation can be an effective treatment; however, lack of OCA bone integration can cause failure. This controlled laboratory study was designed to compare clinically applicable methods for marrow element removal and enhanced delivery of bone marrow aspirate concentrate (BMC) to OCA bone. We hypothesized that compressed carbon dioxide (CO2 ) treatment of OCA bone would result in significantly better marrow element removal, significantly more retention and distribution of viable osteoprogenitor cells, and significantly higher osteoinductive protein elution from OCAs compared with other preimplantation treatments...
March 7, 2018: Journal of Knee Surgery
Michael J Gardner, Thomas A Higgins, William H Harvin, James P Stannard, Mark A Lee, Brett D Crist
Fracture surgeons do a great job of managing bone issues, but they may overlook the associated soft tissue injuries that play a significant role in the final outcome after musculoskeletal injury. The soft tissue reconstruction ladder can help guide reconstructive procedures based on the least complex procedure that allows the best chance of fracture healing. Muscle injury, volume loss, and deconditioning occur with traumatic injury and during the recovery phase. Neuromuscular stimulation, nutrition, and strength training are potential ways to aid in recovery...
March 2018: Journal of Orthopaedic Trauma
Rachel M Frank, Anthony A Romeo, Catherine Richardson, Shelby Sumner, Nikhil N Verma, Brian J Cole, Gregory P Nicholson, Matthew T Provencher
BACKGROUND: Anterior glenoid reconstruction with fresh distal tibia allograft (DTA) has been described for management of recurrent shoulder instability, with encouraging early outcomes; however, no comparative data with the Latarjet procedure are available. PURPOSE: The purpose of this study was to compare the clinical outcomes between patients undergoing DTA and a matched cohort of patients undergoing Latarjet. STUDY DESIGN: Cohort study; Level of evidence, 3...
February 1, 2018: American Journal of Sports Medicine
Kevin C Wang, Brian R Waterman, Eric J Cotter, Rachel M Frank, Brian J Cole
Isolated, full-thickness articular cartilage lesions of the glenohumeral joint can cause pain, mechanical symptoms, and impaired function. Reports on operative management of these injuries with arthroscopic techniques, such as marrow stimulation, have shown improvement in patient symptoms. In cases where the subchondral bone is involved, osteochondral allograft (OCA) transplantation has shown positive results for contained, focal cartilage defects. The technique for OCA transplantation to treat Hill-Sachs lesions has been reported in detail, and there are multiple case series reporting on the outcomes of OCA used for this purpose...
August 2017: Arthroscopy Techniques
Brian E Walczak, Matthew S Nies, Darrin J Trask, Scott Hetzel, Patrick J Roney, Matthew W Squire, Geoffrey S Baer
BACKGROUND: Insertion force has been shown to significantly reduce chondrocyte viability during osteochondral allograft transplantation. How graft size influences the required insertion force and chondrocyte viability has yet to be determined. Hypothesis/Purpose: The purpose was to characterize how graft size influences insertion force requirements and chondrocyte viability during osteochondral transplantation. The hypothesis was that larger grafts would require greater force and reduce chondrocyte viability...
January 1, 2018: American Journal of Sports Medicine
Eric L Johnson, Elisabet K Tassis, Georgina M Michael, Susan G Whittinghill
RATIONALE: Occupational burn injuries can be detrimental and difficult to manage. The majority of complex cases are referred and managed at regional burn centers where access to specialized care is available. As an alternative to hospitalization with staged surgical procedures, placental products may be used for outpatient medical management of these common burn injuries, especially if access to a regional burn center is limited or restricted.Fresh amnion has been a treatment of choice in burns for more than 100 years...
December 2017: Medicine (Baltimore)
Rosario Rizzo, Alessandro Quaranta, Massimo De Paoli, Giorgio Rappelli, Matteo Piemontese
This study proposed a surgical technique that solves three-dimensional conditions of extreme bone atrophy. A total of 278 surgeries with transcrestal sinus lift and fresh frozen allogenous bone blocks were performed. A total of 1,024 implants were placed. After 60 months of observation, 969 implants were considered grade I (successful), 24 grade II (satisfactory survival), and 8 grade III (compromised survival). The cumulative success and survival rates, respectively, were 94.6% and 97.7%. This innovative procedure is very effective in selected cases...
January 2018: International Journal of Periodontics & Restorative Dentistry
Juan Manuel Yañez Arauz, Jorge Javier Del Vecchio, Facundo Bilbao, Nicolas Raimondi
INTRODUCTION: Symptomatic talar osteochondral lesions are about 50% refractory to conservative treatment requiring a surgical solution. In the case of large chronic lesions, the use of bone graft taken from tissue bank is an alternative that enables to fill the defect without causing donor site morbidity. MATERIAL AND METHODS: Eight patients treated with talar osteochondral allograft in lesions greater than 20mm in diameter were analyzed - 4 males and 4 females aging 39...
December 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Marna Ribeiro, Erica Hohlenwerger Fraguas, Keila Ilse Cangussu Brito, Yeon Jung Kim, Debora Pallos, Wilson Roberto Sendyk
OBJECTIVE: This study compared stability, removal torque, bone implant contact (BIC) and area (BA) of implants installed simultaneously with onlay autografts or allografts in rabbits' tibias. MATERIAL AND METHODS: Total of 18 rabbits were used in this study. Fresh frozen allografts were obtained from six animals at T(-6). Two implants with autogenous grafts (Group 1) or allografts (Group 2) were simultaneously inserted into both sides of the tibiae in a vertical periimplant defect model at T0...
January 2018: Journal of Cranio-maxillo-facial Surgery
C Krettek, J-D Clausen, C Neunaber
Cartilage defects in adult patients are so far incurable. Fresh osteochondral allograft (OCA) transplantation is based on the insertion of mature, living, mechanically sound hyaline cartilage into an osteochondral defect where it undergoes osseointegration. Intact hyaline cartilage of OCA does not cause immune reactions in the recipient. Many reports show that small OCA have good osseointegration and show good long-term results. These observations have been incorporated into the development of the fresh large (> 10 cm(2)) osteochondral shell allograft transplantation (FLOCSAT) concept, which is based on the following principles: 1) the thickness of the osseous layer should be kept as thin as possible (target < 6-8 mm) so that the transplant remains stable and fixable...
November 2017: Der Unfallchirurg
C Krettek, J-D Clausen, N Bruns, C Neunaber
Cartilage defects in adult patients do not heal well. Fresh osteochondral allograft (OCA) transplantation is based on mature, living, mechanically sound hyaline cartilage attached to a bone interface, which is brought into an osteochondral defect, where it becomes osseointegrated. According to current knowledge, intact hyaline cartilage tissue is immune privileged and does not, in contrast to bone, meniscus or ligaments, cause an immune reaction. The technique has the unique advantage of transplanting viable, mature and mechanically stable hyaline cartilage into the affected area...
November 2017: Der Unfallchirurg
Justin J Mitchell, Alexander R Vap, George Sanchez, Daniel J Liechti, Jorge Chahla, Gilbert Moatshe, Márcio B Ferrari, Matthew T Provencher
Chronic posterior glenohumeral joint instability can be a challenging clinical entity for patients and surgeons alike. In the setting of a posterior dislocation, a large anterior humeral impaction injury (reverse Hill-Sachs [HS]) may occur, leading to engagement of the humerus with the posterior glenoid bone, especially during internal rotation of the joint. A reverse HS is especially debilitating because of the significant portion of affected humeral head cartilage, and is made worse in the setting of ligamentous disruption such as a posterior humeral avulsion of the glenohumeral ligament (HAGL) lesions...
August 2017: Arthroscopy Techniques
S Schmidt, A Schulte, S Schwarz, N Hofmann, S Tietz, M Boergel, S U Sixt
BACKGROUND: The biggest obstacle to overcome for routine treatment of various pathologies with fresh osteochondral allograft is the availability of tissue for transplantation. Large fresh osteochondral allografts are usually harvested from organ donors, but in contrast to organs, tissues can be procured after cardiac arrest. OBJECTIVE: Medical staff as well the general public are much less aware of the possibilities and requirements of tissue donation compared to organ donation...
November 2017: Der Unfallchirurg
Wei Feng, Dongsong Li, Junting Zang, Li Fu
Bone xenografting is considered one of the most effective ways to address the shortage of bone autografts and allografts. Various methods have been employed to minimize the immune rejection issues associated with bone xenografts. However, the side effects of such methods on bone biomechanical properties remain unclear. As such, the objective of this study was to compare the influence of different treatments on the biomechanical properties of porcine bones. Fresh pig ribs were cut into 1.5 × 0.5 × 0.4 cm specimens, which were randomly divided into four groups and subjected to different modification regimes: group A by degreasing and partial deproteinization, group B by cryopreservation, group C by cryopreservation and enzyme digestion, and group D was a control group using fresh bone...
November 2017: Xenotransplantation
Anand M Murthi, Miguel A Ramirez, Brent G Parks, Shannon R Carpenter
BACKGROUND: The bicipital aponeurosis, or lacertus fibrosus, can potentially be used as a reconstruction graft in chronic distal biceps tendon tears. PURPOSE: To evaluate construct stiffness, load to failure, and failure mechanism with lacertus fibrosus versus Achilles allograft for distal biceps tendon reconstruction. STUDY DESIGN: Controlled laboratory study. METHODS: Ten fresh-frozen matched cadaveric pairs of elbows were used...
December 2017: American Journal of Sports Medicine
Karl J Zeren
This prospective case series enrolled consecutively qualifying patients that required immediate dental implant placement in large, uncontained, fresh molar extraction sites using recombinant human bone morphogentic protein-2/absorbable collagen sponge (rhBMP-2/ACS) combined with mineralized bone allograft. A total of 11 patients with 15 extraction sites missing bony walls were enrolled for treatment in this prospective case series. The clinical and radiographic effectiveness of rhBMP-2/ACS combined with mineralized bone allograft supported healing of immediately placed implants...
August 30, 2017: International Journal of Periodontics & Restorative Dentistry
Kuang-Ting Yeh, Ru-Ping Lee, Ing-Ho Chen, Tzai-Chiu Yu, Kuan-Lin Liu, Cheng-Huan Peng, Jen-Hung Wang, Pau-Yuan Chang, Wen-Tien Wu
Anterior cervical corpectomy and fusion (ACCF) is one of the main surgical strategies for the management of multilevel cervical spondylotic myelopathy (MCSM). High complication rates of graft bone fracture, resorption, displacement, and fusion collapse or pseudarthrosis have been previously reported. The strategies to prevent the aforementioned complications include using fresh frozen cortical strut allograft (FFCSA) to keep most of the original bone quality and using additional anterior plate fixation to improve the fusion stability and union rate...
2017: PloS One
Xifu Shang, Bing Shu, Yongjun Wang, Zhengliang Luo, Guangxi Wang, Shane Barton, Massimo Max Morandi, Christopher Kevil, Yufeng Dong
To determine whether cell sheets generated with long-term passaged (P10) aging human mesenchymal stromal cells (MSCs) could be used for bone tissue regeneration as tissue engineered periosteum in a femoral allograft mouse model similar to fresh passaged (P3) young MSCs. At 3 weeks after transplantation of MSC sheets, results showed more bony callus formed between allograft and host bone ends in both young P3 MSC and aged P10 MSC sheet-wrapped groups when compared to allograft alone. At 6 weeks, while both MSC sheet-wrapped allografts showed more bony callus formation when compared to allograft alone groups, the bony callus size in aged P10 MSC sheet groups was significantly less than young P3 MSC sheet groups...
August 11, 2017: Scientific Reports
Lasun O Oladeji, James P Stannard, Cristi R Cook, Mauricio Kfuri, Brett D Crist, Matthew J Smith, James L Cook
BACKGROUND: Transplantation of fresh osteochondral allografts (OCAs) is an attractive treatment option for symptomatic articular cartilage lesions in young, healthy patients. Because the lack of OCA bone integration can be a cause of treatment failure, methods for speeding and enhancing OCA bone integration to mitigate this potential complication are highly desirable. PURPOSE: To determine if autogenous bone marrow aspirate concentrate (BMC) treatment of large femoral condylar OCAs would be associated with superior radiographic OCA bone integration compared with nontreated allografts during the critical first 6 months after surgery...
October 2017: American Journal of Sports Medicine
Haibo Lu, Haoye Meng, Shibi Lu, Ling Qin, Bin Zhao, Aiyuan Wang, Jiang Peng, Wenjing Xu, Quanyi Guo, Jian Zhang
BACKGROUND: Freeze-dried and irradiated allograft bone (FIAB) is more easily impacted than fresh-frozen allograft bone (FAB), but has weaker incorporation efficiency. We combined FIAB with fresh autologous coagula to enhance donor-host incorporation after impaction during hip revision. METHODS: Thirty adult male Sprague-Dawley (SD) rats were sacrificed for bone allograft harvesting, and nine male rats were subjected to ectopic bone allograft implantation. For each rat, the container on the left (study) side was filled with freeze-dried allograft bone powder and fresh autologous blood coagula, whereas the right (control) side was filled with freeze-dried allograft bone powder and physiological saline...
July 18, 2017: Connective Tissue Research
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