title: Bone graft substitutes for articular support and metaphyseal comminution: what are the options?
abstract: Subchondral and metaphyseal bone defects pose a great challenge for the Orthopaedic surgeon not only because the support for the articular surface has been lost but also because the mechanism for the nourishment of articular cartilage through the subchondral plate is distorted. A number of options are available to the surgeons, none of them perfect. Autografting has an appreciable high rate of harvest site morbidity, allograft is associated with infection transmission and host immunologic response. These realities have stimulated interest in supplying bone replacement materials (demineralised bone matrix, synthetic bone substitutes, bone morphogenic proteins). This paper presents the indications and applications of bone substitutes for metaphyseal defects and subchondral support in orthopaedic trauma.
authors.affiliation: University Hospital Louisville, USA. cmauffrey@yahoo.com
authors.forename: C
authors.initials: C
authors.lastname: Mauffrey
authors.forename: D
authors.initials: D
authors.lastname: Seligson
authors.forename: P
authors.initials: P
authors.lastname: Lichte
authors.forename: H C
authors.initials: HC
authors.lastname: Pape
authors.forename: M
authors.initials: M
authors.lastname: Al-Rayyan
mesh_terms: D020341:Absorbable Implants; D000328:Adult; D000368:Aged; D000818:Animals; D018786:Bone Substitutes / Q000378:metabolism / Q000627:therapeutic use*; D016025:Bone Transplantation; D002130:Calcium Phosphates / Q000378:metabolism / Q000627:therapeutic use; D002133:Calcium Sulfate / Q000378:metabolism / Q000627:therapeutic use; D002358:Cartilage, Articular / Q000473:pathology; D019245:Compressive Strength; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology*; D018460:Fractures, Comminuted / Q000601:surgery; D006801:Humans; D007719:Knee Joint; D008297:Male; D008875:Middle Aged; D016062:Porosity; D013978:Tibial Fractures / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D018786:Bone Substitutes; D002130:Calcium Phosphates; D002133:Calcium Sulfate