scholarly journals Autologous Bone Grafting in Trauma and Orthopaedic Surgery: An Evidence-Based Narrative Review

2021 ◽  
Vol 10 (19) ◽  
pp. 4347
Author(s):  
Filippo Migliorini ◽  
Francesco Cuozzo ◽  
Ernesto Torsiello ◽  
Filippo Spiezia ◽  
Francesco Oliva ◽  
...  
Keyword(s):  
Blood Loss ◽  
Bone Graft ◽  
Bone Grafting ◽  
Orthopaedic Surgery ◽  
Donor Site ◽  
Autologous Bone Graft ◽  
Iliac Crest Bone Graft ◽  
Alternative Source ◽  
Autologous Bone Grafting ◽  
Autologous Bone

Autologous bone grafting is common in trauma and orthopaedic surgery. Both the Reamer Irrigator Aspirator (RIA) and Iliac Crest Bone Graft (ICBG) aim to obtain autologous bone graft. Although the process of harvesting a bone graft is considered simple, complications may occur. This study examined morbidity and pain at the donor site, blood loss, and iatrogenic fractures, comparing RIA and ICBG. The source of the autologous bone graft, the alternative graft sites, and the storage modalities of the harvested bone marrow were also evaluated. In May 2021, PubMed, Embase, Scopus, and Google Scholar were accessed, with no time constraints. RIA may produce greater blood loss, but with less morbidity and complications, making it a potential alternative source of bone grafting.

Vulnerability of the subcostal nerve to injury during bone graft harvesting from the iliac crest

2004 ◽  
Vol 1 (1) ◽  
pp. 87-89 ◽  
Author(s):  
Dean Chou ◽  
Phillip B. Storm ◽  
James N. Campbell
Keyword(s):  
Bone Graft ◽  
Iliac Crest ◽  
Donor Site ◽  
Autologous Bone Graft ◽  
Content Type ◽  
Bone Harvesting ◽  
Cutaneous Branch ◽  
Bone Graft Harvesting ◽  
Autologous Bone ◽  
Fine Print

Object. Autologous bone graft harvesting from the iliac crest remains the gold standard for fusion surgery. One disadvantage of autologous bone harvesting is the patient's enduring postoperative pain at the donor site. Nerve injury is one of the postulated mechanisms that may account for this pain. The object of this study was to determine whether the lateral cutaneous branch of the subcostal nerve is vulnerable to injury in the process of obtaining grafts from the anterior iliac crest. Methods. Anatomical dissections were performed on 10 cadaveric specimens to ascertain the size of the T-12 subcostal nerve and its position in relation to the iliac crest. Conclusions. The lateral cutaneous branch of the subcostal nerve may lie as close as 6 cm from the anterior superior iliac spine. This nerve is very vulnerable to injury when harvesting bone from the anterior iliac crest. Knowledge of the anatomy may decrease the risk of injury to this nerve.

scholarly journals Management of uncontained bone voids with Calcium Sulphate Ceramic (Modified Masquelet / Modified AMIC with Cerament Bio-Composite) Case report and review of literature

2019 ◽  
pp. 1-3
Author(s):  
Ahmed Aljawadi ◽  
Mazin Al-salihy ◽  
Anand Pillai ◽  
Noman Niazi
Keyword(s):  
Bone Graft ◽  
Donor Site ◽  
Calcium Sulphate ◽  
Autologous Bone Graft ◽  
Donor Site Morbidity ◽  
First Case ◽  
Masquelet Technique ◽  
Autologous Bone ◽  
Segmental Bone ◽  
Bone Void

Introduction: Large traumatic bone voids are challenging to treat. Autografts are associated with donor site morbidity and limited availability. Bone graft substitutes are successful alternative to fill bone voids. Case Presentation: The management of two patients with an open tibial fracture with segmental bone loss and other patient with periarticular calcaneal void associated with chondral loss. Treatment and outcomes: For first case, a contained cavity was made using Septocoll E, an absorbable collagen fleece, to mimic a pseudo-membrane using Masquelet-technique. Bone void was filled with Cerament-G and autologous bone graft. Second case with large peri-articular calcaneal void and chondral loss, Cerament-G and autologous bone graft were used, and articular defect reconstruction was done with synthetic chondral tissue. Both patients had painless mobility and consolidation of bone void. Discussion: We represent two exceptional cases of traumatic bone void which were treated with modified masquelet/modified AMIC with Cerament Bio-Composite with satisfactory outcomes

scholarly journals Bone Morphogenetic Proteins in Craniofacial Surgery: Current Techniques, Clinical Experiences, and the Future of Personalized Stem Cell Therapy

2012 ◽  
Vol 2012 ◽  
pp. 1-14 ◽  
Author(s):  
Kristofer E. Chenard ◽  
Chad M. Teven ◽  
Tong-Chuan He ◽  
Russell R. Reid
Keyword(s):  
Stem Cell ◽  
Bone Morphogenetic Proteins ◽  
Bone Grafting ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Experimental Models ◽  
Craniofacial Surgery ◽  
Cell Therapies ◽  
Autologous Bone Grafting ◽  
Autologous Bone

Critical-size osseous defects cannot heal without surgical intervention and can pose a significant challenge to craniofacial reconstruction. Autologous bone grafting is the gold standard for repair but is limited by a donor site morbidity and a potentially inadequate supply of autologous bone. Alternatives to autologous bone grafting include the use of alloplastic and allogenic materials, mesenchymal stem cells, and bone morphogenetic proteins. Bone morphogenetic proteins (BMPs) are essential mediators of bone formation involved in the regulation of differentiation of osteoprogenitor cells into osteoblasts. Here we focus on the use of BMPs in experimental models of craniofacial surgery and clinical applications of BMPs in the reconstruction of the cranial vault, palate, and mandible and suggest a model for the use of BMPs in personalized stem cell therapies.

Local Bone Graft Harvested From the Distal Tibia or Calcaneus for Surgery of the Foot and Ankle

2005 ◽  
Vol 26 (6) ◽  
pp. 449-453 ◽  
Author(s):  
Steven M. Raikin ◽  
Kenneth Brislin
Keyword(s):  
Bone Graft ◽  
Iliac Crest ◽  
Distal Tibia ◽  
Autologous Bone Graft ◽  
Operative Procedures ◽  
Iliac Crest Bone Graft ◽  
Foot And Ankle ◽  
Graft Harvest ◽  
Local Bone ◽  
Autologous Bone

Background: Numerous operative procedures around the foot and ankle use bone graft to augment healing. Autologous bone graft remains the preferred type for these procedures. This can be harvested from the iliac crest, but complications are frequent. The purpose of our study was to investigate the option of harvesting the bone graft from the ipsilateral distal tibia or calcaneus. Method: Bone graft was harvested in 114 patients from the distal tibia (70 patients) or calcaneus (44 patients). The patients were followed postoperatively for an average of 16 (range 5 to 28) months and were evaluated for complications (minor and major), satisfaction, and healing rates. Results: There were no major complications. Ten patients (8.7%) had minor complications including initial incisional sensitivity or local numbness, none of which affected function or required additional treatment. Satisfaction rate for the procedure was 100%. Conclusion: Use of autologous bone graft harvested from the ipsilateral distal tibia or calcaneus is a safe and reliable alternative to iliac crest bone graft harvest for operative procedures of the foot and ankle.

Bone Graft Harvesting From the Calcaneus Using Lateral Wall Corticotomy Technique by an Osteotome

2020 ◽  
pp. 193864002091626
Author(s):  
Farough Khademi ◽  
Amirhossein Erfani ◽  
Mohammad Ali Erfani ◽  
Amir Reza Vosoughi
Keyword(s):  
Bone Graft ◽  
Sural Nerve ◽  
Donor Site ◽  
Case Series ◽  
Pathologic Fracture ◽  
Lateral Wall ◽  
Autologous Bone Graft ◽  
Hematoma Formation ◽  
Bone Graft Harvesting ◽  
Autologous Bone

Background: The aim of this study was to evaluate the complications following calcaneal autologous bone graft harvesting using an osteotome in patients who underwent foot and ankle surgery with follow-up of at least 1 year. Methods: In a cohort study, all consecutive patients underwent forefoot or midfoot surgeries in conjunction with harvesting bone graft from the calcaneus using lateral wall corticotomy technique by an osteotome from 2015 till 2018 were asked to follow. The outcome and morbidity were assessed by visual analogue scale (VAS) pain, numbness in territory of the sural nerve, surgical site numbness or tenderness, infection, hematoma formation, or pathologic fracture. Also any possible restrictions on wearing desired shoes were asked. Results: Totally, 50 patients (11 males, 39 females; 29 right foot, 21 left foot) with the mean age of 48.2 ± 13.8 years (range 8-66 years) were assessed. There were no major complications on donor site such as infection, hematoma formation, or pathologic fracture. The following results were seen; 90% without any pain (VAS 0/10), 96% without numbness at the incision site, 96% without point tenderness on lateral of heel, 98% without paresthesia or numbness in the sural nerve territory, and 84% were able to wear their favorite shoes. Forty-one (82%) cases said if they need another foot surgery, they would permit to harvest bone graft from their heel. Conclusions: Autologous bone graft harvesting from the calcaneus using lateral wall corticotomy technique by an osteotome could be a useful method with very low complications. Levels of Evidence: Therapeutic, level IV: cohort, case series

scholarly journals Large Osteochondral Lesions of the Talus Treated With Autologous Bone Graft and Periosteum Transfer

2019 ◽  
Vol 4 (3) ◽  
pp. 247301141987403
Author(s):  
Dimitrios Nikolopoulos ◽  
Neoptolemos Sergides ◽  
George Safos ◽  
Konstantinos Moustakas ◽  
Petros Safos ◽  
...  
Keyword(s):  
Bone Graft ◽  
Donor Site ◽  
Autologous Transplantation ◽  
Case Series ◽  
Autologous Bone Graft ◽  
Osteochondral Lesions ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Functional Scores ◽  
Autologous Bone

Background: The treatment of large osteochondral lesions of the talus (OLTs) is challenging due to the poor intrinsic reparative capability of the damaged articular cartilage. Autologous transfer of bone and periosteum has been used successfully in the treatment of large defects in animals, and therefore it was believed that this technique might show similar results in humans. The purpose of this study was to assess the outcome of an innovative technique for autologous transplantation of cancellous tibial graft with periosteal transfer in large OLTs. Methods: Forty-one patients (22 females, 19 males), with a mean age of 34.9 years (range, 18-72 years), with a large OLT (>200 mm2) were treated with autologous bone graft and periosteum transfer. OLTs averaging 310 mm2 were identified on a preoperative computed tomography scan. The procedure consisted of malleolar osteotomy, curettage of sclerotic bone, autologous bone graft from the proximal tibia, and transfixion of periosteum over the graft. Outcome measures, including the pain visual analog scale (VAS), ankle range of motion (ROM), American Orthopaedic Foot & Ankle Society (AOFAS) score, and Foot & Ankle Disability Index (FADI), were compared between preoperative and 1 and 2 years following surgery. Results: There were significant improvements in VAS pain score from 7.7 before surgery to 1.1 at 1 year after surgery and 0.4 at 2 years or more after surgery. The AOFAS and FADI scores were also significantly improved from 40.3 and 53.3 preoperatively to 95 and 93.2 postoperatively at 1 year and 95 and 93.2 at 2 or more years postoperatively, respectively. Postoperative complications included 2 patients who required removal of medial malleolar osteotomy tension bands due to symptomatic hardware. There were no nonunions or malunions of the osteotomies and no donor site complications. Conclusion: Autologous bone graft and periosteum transfer was an effective treatment for large OLTs leading to significant decreases in pain and improvement in functional scores at more than 2 years after surgery. Level of Evidence: Level IV, retrospective case series.

Combining Microfractures, Autologous Bone Graft, and Autologous Matrix-Induced Chondrogenesis for the Treatment of Juvenile Osteochondral Talar Lesions

2017 ◽  
Vol 38 (5) ◽  
pp. 485-495 ◽  
Author(s):  
Riccardo D’Ambrosi ◽  
Camilla Maccario ◽  
Chiara Ursino ◽  
Nicola Serra ◽  
Federico Giuseppe Usuelli
Keyword(s):  
Bone Graft ◽  
Repeated Measures ◽  
Osteochondral Lesion ◽  
Young Patients ◽  
Case Series ◽  
Autologous Bone Graft ◽  
Lesion Size ◽  
Level Of Evidence ◽  
Significant Difference ◽  
Autologous Bone

Background: The purpose of this study was to evaluate the clinical and radiologic outcomes of patients younger than 20 years, treated with the arthroscopic-talus autologous matrix-induced chondrogenesis (AT-AMIC) technique and autologous bone graft for osteochondral lesion of the talus (OLT). Methods: Eleven patients under 20 years (range 13.3-20.0) underwent the AT-AMIC procedure and autologous bone graft for OLTs. Patients were evaluated preoperatively (T0) and at 6 (T1), 12 (T2), and 24 (T3) months postoperatively, using the American Orthopaedic Foot & Ankle Society Ankle and Hindfoot (AOFAS) score, the visual analog scale and the SF-12 respectively in its Mental and Physical Component Scores. Radiologic assessment included computed tomographic (CT) scan, magnetic resonance imaging (MRI) and intraoperative measurement of the lesion. A multivariate statistical analysis was performed. Results: Mean lesion size measured during surgery was 1.1 cm3 ± 0.5 cm3. We found a significant difference in clinical and radiologic parameters with analysis of variance for repeated measures ( P < .001). All clinical scores significantly improved ( P < .05) from T0 to T3. Lesion area significantly reduced from 119.1 ± 29.1 mm2 preoperatively to 77.9 ± 15.8 mm2 ( P < .05) at final follow-up as assessed by CT, and from 132.2 ± 31.3 mm2 to 85.3 ± 14.5 mm2 ( P < .05) as assessed by MRI. Moreover, we noted an important correlation between intraoperative size of the lesion and body mass index (BMI) ( P = .011). Conclusions: The technique can be considered safe and effective with early good results in young patients. Moreover, we demonstrated a significant correlation between BMI and lesion size and a significant impact of OLTs on quality of life. Level of Evidence: Level IV, retrospective case series.

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