The efficacy of application of lyophilized, radiation-sterilized bone graft in orthopedic surgery.
The purpose of this study is retrospective analysis of clinical application of lyophilized (freeze-dried), radiation-sterilized allografts in various orthopedic disorders. Grafts of this type have been produced by Polish tissue banks for many years, even before the production of deep-frozen grafts was started. This type of graft is still produced because of their easy storage, transportation, and distribution. Their application is successful in selected cases. Freeze-dried, radiation-sterilized cancellous or cortical-cancellous blocks, cancellous chips, or diaphyseal cortical struts were applied in 435 patients ranging from three to 74 years old. There were five main groups of procedures: posterior or anterior spine fusion, 224 cases; joint arthrodeses, 36 cases; reconstructive operations, 83 cases; filling of bone lesions, 59 cases; and posttraumatic reconstructive operations, 33 cases. The efficacy of application of lyophilized, radiation-sterilized allografts was estimated retrospectively on the basis of physical examination data and roentgenographic assessment collected during postoperative visits. Incorporation and rebuilding of the grafts as well as a satisfactory therapeutic effect were achieved in 394 (91%) patients. Excluding the cases of congenital and hypovascular pseudoarthroses, post-osteomyelitis gap and focuses, as well as Stage 2 bone lesions, it is suggested that lyophilized, radiation-sterilized allografts can be applied on the condition that intimate contact between the donor bone and host bed is complete and sustained.
Department of Orthopaedics, Postgraduate Medical Education Academy, Otwock, Poland.
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Zasacki
D000293:Adolescent; D000328:Adult; D000368:Aged; D001174:Arthrodesis / Q000379:methods; D001847:Bone Diseases / Q000601:surgery*; D016025:Bone Transplantation / Q000009:adverse effects; D001842:Bone and Bones / Q000528:radiation effects*; D002648:Child; D002675:Child, Preschool; D005612:Freeze Drying; D006801:Humans; D008875:Middle Aged; D010019:Osteomyelitis / Q000209:etiology; D012189:Retrospective Studies; D013242:Sterilization / Q000379:methods*; D013530:Surgical Wound Infection / Q000209:etiology; D014021:Tissue Preservation