Fresh-frozen vs. irradiated allograft bone in orthopaedic reconstructive surgery

doi:10.1016/j.injury.2009.01.116

Injury

Volume 40, Issue 12, December 2009, Pages 1260-1264

https://doi.org/10.1016/j.injury.2009.01.116 Get rights and content

Abstract

The use of allograft bone is increasingly common in orthopaedic reconstruction procedures. The optimal method of preparation of allograft bone is subject of great debate. Proponents of fresh-frozen graft cite improved biological and biomechanical characteristics relative to irradiated material, whereas fear of bacterial or viral transmission warrants some to favour irradiated graft. Careful review of the literature is necessary to appreciate the influence of processing techniques on bone quality. Whereas limited clinical trials are available to govern the selection of appropriate bone graft, this review presents the argument favouring the use of fresh-frozen bone allograft as compared to irradiated bone.

Section snippets

Conflict of Interest

Neither author has received any financial contributions relevant to this article, nor do they have any personal relationship with any persons affiliated with organizations which could inappropriately bias this work. D. Costain's Orthopaedic Fellow salary is partly funded by Stryker.

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Furthermore, these complications have been shown to be reduced when the allografts were covered with vascularized tissue flaps [115,116]. Unfortunately, the processes of freezing, impacting and rinsing, irradiating, freeze-drying, demineralizing, and deproteinizing allograft aim to reduce its immunogenic potential but may also decrease graft mechanical properties and repopulation potential [117–123]. Bone marrow is seen as a ready supply of viable bone elements.
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ReviewFresh-frozen vs. irradiated allograft bone in orthopaedic reconstructive surgery

Abstract

Section snippets

Conflict of Interest

J Orthop Res

J Orthop Res

J Biomech

Biomaterials

Ortho Clin North Am

Ortho Clin North Am

J Arthroplasty

Biomaterials

J Arthroplasty

Biomaterials

J Arthroplasty

J Orthop Res

Ortho Clin North Am

J Arthroplasty

Compressive mechanical properties of human cancellous bone after gamma irradiation

J Bone Joint Surg Am

Results of impaction grafting in revision hip arthroplasty at two to seven years using fresh and irradiated allograft bone

Hip Int

Mechanical behavior of human morselized cancellous bone in triaxial compression testing

J Orthop Res

Bone transplantation and human immunodeficiency virus. An estimate of risk of acquired immunodeficiency syndrome (AIDS)

Clin Orthop Relat Res

Irradiated allograft bone for acetabular revision surgery. Results at a mean of five years

J Bone Joint Surg Br

Bacterial- and fungal-positive cultures in organ donors: clinical impact in liver transplantation

Liver Transpl

BMP-7 and CBFA1 in allograft bone in vivo bone formation and the influence of γ-irradiation

J Biomed Mat Res

To determine the effects of ultraviolet light, natural light and ionizing radiation on pyridinium cross-links in bone and urine using high-performance liquid chromatography

Eur J Clin Invest

Effect of freeze-drying and gamma irradiation on the mechanical properties of human cancellous bone

J Orthop Res

Impaction bone grafting with freeze-dried irradiated bone. Part I. Femoral implant stability: cadaver experiments in a hip simulator

Acta Orthop Scand

Impaction bone grafting with freeze-dried irradiated bone. Part II. Changes in stiffness and compactness of morselized grafts: experiments in cadavers

Acta Orthop Scand

Effects of ionizing radiation on the mechanical properties of human bone

J Orthop Res

Human bone allografts can induce T cells with high affinity for donor antigens

J Bone Joint Surg Br

Review
Fresh-frozen vs. irradiated allograft bone in orthopaedic reconstructive surgery