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Hospital Medicine (London, England :... Apr 2003Bony deficiency, particularly loss of bone stock associated with failed joint replacements or tumours, is a challenging problem in orthopaedic surgery. Bone... (Review)
Review
Bony deficiency, particularly loss of bone stock associated with failed joint replacements or tumours, is a challenging problem in orthopaedic surgery. Bone transplantation techniques provide solutions that can be tailored to the clinical problem. However, the risks of bone transplantation are well documented and the biology of allograft incorporation remains unpredictable and poorly understood.
Topics: Bone Morphogenetic Protein 7; Bone Morphogenetic Proteins; Bone Transplantation; Humans; Sterilization; Tissue Donors; Transforming Growth Factor beta; Transplantation Immunology; Transplantation, Autologous; Transplantation, Homologous
PubMed: 12731131
DOI: 10.12968/hosp.2003.64.4.1777 -
Orthopedics May 2004
Review
Topics: Bone Transplantation; Bone and Bones; Humans; Transplantation, Autologous; Transplantation, Homologous
PubMed: 15181946
DOI: 10.3928/0147-7447-20040501-17 -
Archives of Orthopaedic and Trauma... 1990According to one principle of surgery, the transplantation of vital tissue is the best method of reconstructing a defect. Because of absent immunologic reactions, high...
According to one principle of surgery, the transplantation of vital tissue is the best method of reconstructing a defect. Because of absent immunologic reactions, high osteogenic potency, and preserved stability, transplantation of autogenous bone shows the best results. Necrosis of transplanted bone, leading inevitably to absorption and remodeling of the graft, can be avoided if microsurgically vascularized autogenous bone segments are transferred. Disadvantages are the low availability and the necessity of additional operations. As an alternative, deep-frozen allogeneic bone is used. However, this kind of bone shows delayed incorporation based on cellular and humoral immune reactions, and it is also installed into the host bed after overcoming the immune barrier. The risk of microbiological contamination or transmission of unrecognized germs such as HIV is a cause of great expense in bone banking techniques. If one succeeds in reducing (a) the immunologic defense reaction and (b) the risk of infection by sterilization or disinfection without damaging the osteoinductive proteins of bone matrix, the rate of complications can be lowered. Demineralized bone matrix can be used if biomechanical stability is not required. Its ability to induce osteogenesis without a major immune reaction or the risk of transmitting diseases justifies its clinical application. Further intensive research in these areas is unavoidable.
Topics: Bone Transplantation; History, 17th Century; History, 19th Century; History, 20th Century; Humans
PubMed: 2188633
DOI: 10.1007/BF00441902 -
Archives of Orthopaedic and Trauma... 1995Allogeneic transplantation of human cancellous and cortical bone is a controversially discussed concept in trauma and orthopaedic surgery. Biological and immunological... (Review)
Review
Allogeneic transplantation of human cancellous and cortical bone is a controversially discussed concept in trauma and orthopaedic surgery. Biological and immunological arguments support transplantation of autologous material whenever this is technically possible. On the other hand, synthetic alloplastic materials for bone substitution are available free of immunological and hygienic hazards. In this context the value of allogeneic bone grafts is discussed, especially considering the problem of AIDS. If autologous corticospongious bone is to be used its supply is limited. On the other hand, alloplastic synthetic artificial bone does not meet all the requirements demanded for substitution of large osseous defects up to now. The problems of geometric and mechanical stability of these alloplastic materials still remain. Therefore, no alternative to allografting of large, stable, corticospongious fragments exists in some cases. Bone transplantation is performed without vital indication in nearly every case. Thus an optimum of hygienic security has to be claimed for recipients of allogeneic bone. The "Munich model" for bone transplantation is presented and discussed.
Topics: Acquired Immunodeficiency Syndrome; Bone Transplantation; Communicable Diseases; Contraindications; Graft Survival; Humans; Risk; Transplantation Immunology; Transplantation, Homologous
PubMed: 7619637
DOI: 10.1007/BF00443390 -
Medecine Sciences : M/S Jan 2017Bone substitutes, used to fill a defect after a surgery or a trauma, provide a mechanical support and might induce bone healing. They constitute an alternative to... (Review)
Review
Bone substitutes, used to fill a defect after a surgery or a trauma, provide a mechanical support and might induce bone healing. They constitute an alternative to autogenous bone grafts, the 'gold standard' which remains the reference despite its risk of postoperative complications. The clinician choice of a bone substitute is based on the required bone volume, the handling (injectability, malleability) and mechanical properties (setting time, viscosity, resorbability among others) of the material. Bone substitutes are commonly used in orthopedic surgery, neurosurgery, stomatology and dental applications. Their use increases steadily, with the recent clinical development of injectable forms. In addition, novel technologies by subtractive or additive techniques allow today the production of controlled architecture materials. Here, we present a bone substitutes classification according to their origin (natural or synthetic) and chemical composition, and the most common use of these substitutes.
Topics: Allografts; Animals; Anthozoa; Biocompatible Materials; Bone Substitutes; Bone Transplantation; Heterografts; Humans; Plants
PubMed: 28120757
DOI: 10.1051/medsci/20173301010 -
Expert Opinion on Biological Therapy Jun 2010Bone is one of the most transplanted tissues worldwide. Autograft is the ideal bone graft but is not widely used because of donor site morbidity and restricted... (Review)
Review
IMPORTANCE OF THE FIELD
Bone is one of the most transplanted tissues worldwide. Autograft is the ideal bone graft but is not widely used because of donor site morbidity and restricted availability. Allograft is easily accessible but can transmit infections and elicit an immune response.
AREAS COVERED IN THIS REVIEW
This review identifies all in vitro and in vivo evidence of immune responses following bone transplantation and highlights methods of improving host tolerance to bone allotransplantation.
WHAT THE READER WILL GAIN
In humans, the presence of anti-HLA specific antibodies against freeze-dried and fresh-frozen bone allografts has been demonstrated. Fresh-frozen bone allograft can still generate immune reactions whilst freeze-dried bone allografts present with less immunogenicity but have less structural integrity. This immune response can have an adverse effect on the graft's incorporation and increase the incidence of rejection. Decreasing the immune reaction against the allograft by lowering the immunogenic load of the graft or lowering the host immune response, would result in improved bone incorporation.
TAKE HOME MESSAGE
It is essential that the complex biological processes related to bone immunogenicity are understood, since this may allow the development of safer and more successful ways of controlling the outcome of bone allografting.
Topics: Animals; Antigens; Bone Diseases; Bone Matrix; Bone Transplantation; Humans; Immunosuppressive Agents; Transplantation, Autologous; Transplantation, Homologous
PubMed: 20415596
DOI: 10.1517/14712598.2010.481669 -
The British Journal of Theatre Nursing... May 1992Organ transplantation is a recognised surgical procedure. Bone transplantation (allografting) is a procedure being used increasingly in Orthopaedic reconstructive...
Organ transplantation is a recognised surgical procedure. Bone transplantation (allografting) is a procedure being used increasingly in Orthopaedic reconstructive surgery. It involves the transplantation of bone between two unrelated individuals. This technique started expanding in the 1970's in the US and Canada and is rapidly gaining popularity in the UK. No blood grouping or tissue typing is required and the recipient does not need immunosuppressive therapy.
Topics: Bone Transplantation; Humans; Tissue Preservation
PubMed: 1627841
DOI: No ID Found -
Curationis Dec 1990Two different methods of transplantation are available. The allogeneic procedure is the transfer of bone marrow between compatible siblings, whereas in autografting the... (Review)
Review
Two different methods of transplantation are available. The allogeneic procedure is the transfer of bone marrow between compatible siblings, whereas in autografting the patient's own haematopoietic stem cells are collected, stored, and subsequently reinfused. Both forms have become established in the treatment of the leukaemias, aplastic anaemia, the malignant lymphomas, myeloma and certain immunologic diseases. Similarly, these techniques are being used in solid tumour oncology to reconstitute bone marrow function after high doses of chemotherapy, which would otherwise result in irreversible myelotoxicity. The success of such programmes depends upon a well developed multidisciplinary approach, prominently involving experienced and dedicated nursing staff. The latter individuals will establish contact with the patient typically during the first admission for chemotherapy and this will be consolidated during subsequent outpatient visits. Then follows the highly specialised care of central venous lines and management of radiation or chemotherapy-related side effects, often with intensive care needed for safe reversal of sepsis that may, however, be associated with renal or cardiorespiratory dysfunction. Most importantly, and again centrally involving the professional nurse, is responsibility for all aspects of maintaining and operating the protected environment, together with laminar air-flow rooms. Additional interaction is also necessary with dieticians, social workers, liaison psychiatrists, occupational therapists and frequently the infectious disease, cardiovascular, respiratory and renal services. Furthermore, achievement of optimal results presupposes the availability of a dedicated cell support section, as well as the competence to cryopreserve haematopoietic stem cells and monitor the safety of this step with in vitro bone marrow culture--another role for the specialised or academic nurse.(ABSTRACT TRUNCATED AT 250 WORDS)
Topics: Bone Transplantation; Graft Rejection; Graft vs Host Disease; Humans; Job Description; Leukemia; Patient Care Team; Survival Rate
PubMed: 2091866
DOI: No ID Found -
Orthopedics Aug 1993
Review
Topics: Bone Transplantation; History, 18th Century; History, 19th Century; History, 20th Century; Humans
PubMed: 8415273
DOI: 10.3928/0147-7447-19930801-08 -
The Orthopedic Clinics of North America Oct 1999Because the biomechanical competence of the graft is a central issue, many research studies of bone grafts include a biomechanical component. The biomechanical... (Comparative Study)
Comparative Study Review
Because the biomechanical competence of the graft is a central issue, many research studies of bone grafts include a biomechanical component. The biomechanical evaluation serves as a bottom-line measure of the experimental outcome in which some measure of mechanical performance is compared among treatment groups. This article considers the biomechanics of grafts in the context of this experimental work and focuses on three issues: (1) the interplay between biology and biomechanics of grafts, (2) the effects of treatment choices on biomechanical properties, and (3) model factors that may influence biomechanical performance.
Topics: Biology; Biomechanical Phenomena; Bone Substitutes; Bone Transplantation; Bone and Bones; Humans; Stress, Mechanical; Tissue Preservation; Treatment Outcome
PubMed: 10471760
DOI: 10.1016/s0030-5898(05)70108-5