An overview of the histology of skeletal substitute materials.
BACKGROUND
Orthopedic and spine surgeons are in frequent need of bone for skeletal reconstruction. The amount of autograft is limited, and conventional allograft has some disadvantages, so surgeons are now using increasing amounts of demineralized allograft and a variety of synthetic materials to replace or "extend" autograft.


OBJECTIVE
To provide an overview of the composition and histology of the materials most likely to be seen by pathologists today.


METHODS
The review is based on published literature and the author's experience with preclinical studies and human biopsies.


CONCLUSIONS
Pathologists are likely to find these skeletal substitute materials in biopsy and resection specimens from patients who have undergone prior treatment, and recognizing a synthetic bone substitute can help explain an otherwise confusing specimen. Pathologists also play an important role in helping define the safety and efficacy of new bioactive materials.
Bauer
Thomas W
TW
Department of Pathology, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44106, USA. osteoclast@aol.com
D000818:Animals; D001696:Biomechanical Phenomena; D001843:Bone Cements / Q000627:therapeutic use; D001847:Bone Diseases / Q000628:therapy*; D019485:Bone Morphogenetic Proteins / Q000627:therapeutic use; D018786:Bone Substitutes / Q000627:therapeutic use*; D016025:Bone Transplantation / Q000379:methods; D017610:Calcium Compounds / Q000627:therapeutic use; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use; D008422:Materials Testing; D014182:Transplantation, Autologous / Q000379:methods; D014184:Transplantation, Homologous / Q000379:methods
D001843:Bone Cements; D019485:Bone Morphogenetic Proteins; D018786:Bone Substitutes; D017610:Calcium Compounds; D006820:Hyaluronic Acid