Different Types Of Bone Grafts Research Articles

The Efficiency of Highly Porous β-Tricalcium Phosphate With Bone Marrow Aspirate Concentrate in Midfoot Joint Arthrodesis.

Nonunion is one of the most common and devastating complications following midfoot joint arthrodesis. Many different types of bone grafts and bone substitutes have been used to promote osseous fusion. However, there is no consensus on the gold standard bone grafting material and whether biologic materials should be used alone or in combination. The purpose of this study is to investigate the efficiency of highly porous β-tricalcium phosphate (β-TCP) with bone marrow aspirate concentrate (BMAC) in midfoot joint arthrodesis. This retrospective comparative study included patients who underwent midfoot joint arthrodesis using compression screws. Patients were classified into 2 groups: arthrodesis with highly porous β-TCP and BMAC (group A) and arthrodesis without them (group B). The osseous union rate was compared between the 2 groups. A total of 44 patients (46 feet) including 89 joints were included in this study. There was a significant difference in the union rate between the 2 groups: 91.5% (43/47 joints) in arthrodesis with highly porous β-TCP and BMAC (group A) and 76.2% (32/42 joints) in arthrodesis without highly porous β-TCP and BMAC (group B; P = .048). This study investigated the efficiency of highly porous β-TCP and BMAC to promote bony healing in midfoot joint arthrodesis. A significantly higher union rate was shown when arthrodesis was performed with highly porous β-TCP and BMAC, compared with arthrodesis performed without them. We suggest that highly porous β-TCP and BMAC can be a viable and effective adjunct to the fixation in midfoot joint arthrodesis. Level III: Retrospective comparative analysis.

Clinical and Kinematic Outcomes Based on Bone Graft Utilization for Salvage First Metatarsophalangeal Arthrodesis: A Systematic Review

Motion-preserving options for the treatment of first metatarsophalangeal (MTP) osteoarthritis are appealing, but the conversion to arthrodesis in failed cases comes with additional challenges. Loss of first ray length may not only lower arthrodesis success rates but can also cause aberrancies in the biomechanics of the foot and ankle. Selection of the proper graft for the restoration of length is crucial in order to minimize the chance of post-operative complications. The primary objective of this systematic review was to determine the optimal graft type for MTP salvage arthrodesis in terms of clinical outcomes, kinematic outcomes, and bony integration to improve patient care. A systematic review was performed using PubMed, SPORTDiscus, Cumulated Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, and Web of Science from database inception until 20 June 2023. Inclusion criteria were articles that examined clinical outcomes, examined different types of bone grafts, discussed impact of bone graft on lengthening, and articles related to first MTP arthrodesis salvage procedures. Data extraction relating to clinical metrics and kinematic metrics was performed and analyzed. Subgroup analysis was performed to compare graft types, such as (1) foot and ankle autograft, (2) non-foot and ankle autograft, and (3) allograft. A total of ten articles met eligibility criteria from 180 articles initially retrieved. Included patients (n = 164) had a frequency-weighted mean age of 55.2 ± 4.6 years with a frequency-weighted mean time from primary to salvage procedure of 36.6 ± 21.9 months and a frequency-weighted mean follow-up time of 42.7 ± 17.4 months. The non-foot and ankle autograft group had a mean length restoration of 4.4 ± 0.1 mm (n = 33, 73.3% reported) whereas the allograft group had a mean length restoration of 7.6 ± 3.5 mm (n = 49, 100% reported). The foot and ankle autograft group (n = 12 procedures) had an overall complication rate of 25.0%, the non-foot and ankle autograft group (n = 45 procedures) had an overall complication rate of 53.3%, and the allograft group (n = 49 procedures) had an overall complication rate of 10.2%. Preoperative AOFAS scores were lower but improved postoperatively, with the allograft group showing the highest postoperative scores, shorter time to union, and varying graft lengths among different autograft subgroups. The allograft group for salvage MTP arthrodesis has promise, as this group had the greatest mean length restoration and the lowest complication rate. This is the first systematic review examining different bone graft utilization for salvage MTP arthrodesis. More high-quality research is needed before solid recommendations can be made on this topic.

Investigation of Different Types of Micro- and Nanostructured Materials for Bone Grafting Application.

The insufficient volume of dental ridges is one of the most severe problems regarding an oral cavity. An inadequate amount can cause problems during various types of dental treatment. Its complexity originates from the etiopathogenesis of this problem. In this study, the representatives of auto-, allo-, and xenografts are compared. The physic-chemical differences between each of them were evaluated using XRD (X-ray Powder Diffraction), a SEM (Scanning Electron Microscopy), FT-IR (Fourier transformed infrared spectroscopy), and TGA (thermogravimetric analysis). Based on the SEM images, it was observed that the origin of the material has an influence on collagen fiber compact level and porosity. Following a comparison of FT-IR spectra and XRD, the crystal and chemical structures were described. Based on TGA, different water concentrations of the investigated materials, their high thermal stability, and concentration of inorganic phase, hydroxyapatite was determined. The presented study is important because it delivers information about chemical structure and its impact on bone regeneration. This knowledge should be taken into consideration by dental clinicians, because different types of bone grafts can accommodate the achievement of various goals.

The Efficiency of Highly Porous β-Tricalcium Phosphate (β-TCP) with Bone Marrow Aspirate Concentrate (BMAC) in Midfoot Joint Arthrodesis

Category: Midfoot/Forefoot Introduction/Purpose: Nonunion is one of the most common and devastating complications following midfoot joint arthrodesis. Many different types of bone grafts and bone substitutes have been used to promote osseous fusion. However, there is no consensus on the gold standard bone grafting material and whether biologic materials should be used alone or in combination. The purpose of this study is to investigate the efficiency of highly porous β-tricalcium phosphate (β-TCP) with Bone Marrow Aspirate Concentrate (BMAC) in midfoot joint arthrodesis. Methods: This retrospective comparative study included patients who underwent midfoot joint arthrodesis using compression screws from January 2014 to May 2019. A total of 44 patients (46 feet) including 89 joints were included in this study. The cohort was then stratified into two groups: 25 patients (26 feet) in arthrodesis with highly porous β-TCP and BMAC (group A) and 19 patients (20 feet) in arthrodesis without highly porous β-TCP and BMAC (group B). The osseous union rate was compared between the two groups. Demographic and operative data including age, sex, body mass index (BMI), smoking, etiology of arthritis, comorbidities such as diabetes mellitus and rheumatoid arthritis, number of joints fixed, use of bone graft or bone substitute, and postoperative midfoot anatomic alignment in the two groups were compared. Results: There was a significant difference in the union rate between the two groups: 91.5 % (43 out of 47 joints) in arthrodesis with highly porous β-TCP and BMAC (group A) and 76.2 % (32 out of 42 joints) in arthrodesis without highly porous β-TCP and BMAC (group B) (P = 0.048). During the follow-up period, a total of four postoperative complications were reported in this study. In group A, two patients developed hardware irritation, and all of them underwent removal of hardware procedure. In group B, one patient had a superficial wound infection, which was resolved completely without further treatment. The other patient in group B developed a deep wound infection with dehiscence, and it was managed with irrigation and debridement followed by vacuum assisted wound closure therapy. Conclusion: This study investigated the efficiency of highly porous β-TCP and BMAC to promote bony healing in midfoot joint arthrodesis. A significantly higher union rate was shown when arthrodesis was performed with highly porous β-TCP and BMAC compared to arthrodesis without them, suggesting that highly porous β-TCP and BMAC can be a viable and effective adjunct to the fixation in midfoot joint arthrodesis.

Top 50 Cited Bone Graft Orthopedic Papers.

The purpose of this research is to recognize the highest 50 most-mentioned articles in the literature concentrating on bone grafts. That has been accomplished with the use of the Scopus database and the search slogan "bone grafts," and we inquired for the 50 most-cited articles on bone grafting. The study was completed in September 2020. We investigated the articles issued between 1970 and 2020. The articles were organized and classified based on the total number of citations. We appraised the following information relating to each article: first author, year of publication, journal, and title.A total of 1,580 studies matched our search standards, of which the 50 most-cited extended between 1,862 and 403 citations. Seven articles were cited more than 1,000 times. The article by Marx et al. was the maximum-cited article, with 1,862 citations, followed by Younger et al.'s with 1,461 and Giannoudis et al.'s with 1,245. The majority of the studies originated from the United States (n = 30) and were published in the 2000s. Biomaterials was the most regular destination journal (n = 8), followed by the Journal of Bone and Joint Surgery American series (n = 7). A maximum of the articles focused on the different types of bone grafts and their alternatives including bone tissue engineering (n=29). Our investigation of the highest 50 articles linking to bone grafting has emphasized the most significant papers in the field. These cover a wide-ranging variety of topics including types, management, and mechanism of action of bone grafts. To recognize the present treatment guidelines and how the use of bone grafting has grown, it is vital to know the most-cited articles relating to this grafting.

Rehabilitation of Maxillary Posterior Edentulism with Direct Antroplasty and Dental Implants: A comparative analysis of two different types of bone grafts

Aims - To determine the difference in the amount of bone generated from two different sites for bilateral maxillary sinus augmentation. Introduction-Rehabilitation of the edentulous posterior maxilla with an implant supported prosthesis is a commonly occurring challenge in dental practice. Objectives - Achieving adequate height of alveolar bone for placing dental implants requires uplifting of the sinus lining in many such cases. This is generally done by harvesting bone grafts from various sites and placing it in the defect created after raising the sinus lining thus restoring the height and width of residual alveolar bone. Objectives - To determine if regional sites of bone graft harvest are equally effective when compared with distant site. Material & Methods - In this series, out of 3 of our patients, two received autologous chin grafts and one patient received PCBM graft from the iliac crest. In all 3 patients, implants were placed in the second stage. Results -Acomparative analysis of the feasibility of the two techniques which involves bone grafts from two sites which have different quality of bone available over the end outcome was done and it was found that the quality of bone available for implant placement was almost the same irrespective of the graft harvest site. Conclusion - It can be safely concluded chin graft is a viable alternative to cortico-cancellous bone graft in cases of direct sinus lift procedures with minimal issues of donor site morbidity.

Multiple Porous Synthetic Bone Graft Comprising EngineeredMicro-Channel for Drug Carrier and Bone Regeneration.

Due to high demand but limited supply, there has been an increase in the need to replace autologous bone grafts with alternatives that fulfill osteogenic requirements. In this study, two different types of bone grafts were tested for their drug carrying abilities along with their osteogenic properties. Two different types of alendronate-loaded bone grafts, Bio-Oss (bovine bone graft) and InRoad (biphasic synthetic bone graft) were observed to see how different concentrations of alendronate would affect the sustained release to enhance osteogenesis. In this study, defected ovariectomize-induced osteoporotic rat calvarias were observed for 28 days with three different concentrations of alendronate (0 mg, 1 mg, 5 mg) for both Bio-Oss and InRoad. A higher concentration (5 mg) allowed for a more controlled and sustained release throughout the 28-day comparison to those of lower concentrations (0 mg, 1 mg). When comparing Bio-Oss and InRoad through histology and Micro-CT, InRoad showed higher enhancement in osteogenesis. Through this study, it was observed that alendronate not only brings out robust osteogenesis with InRoad bone grafts, but also enhances bone regeneration in an alendronate-concentration-dependent manner. The combination of higher concentration of alendronate and multiple porous bone graft containing internal micro-channel structure of InRoad resulted in higher osteogenesis with a sustained release of alendronate.

The clinical use of bone graft substitutes in orthopedic surgery in Germany-A 10-years survey from 2008 to 2018 of 1,090,167 surgical interventions.

Aim of the study was to evaluate (1) the overall use of bone graft substitutes, autografts and allografts, (2) of different types of bone graft substitutes (calcium sulfate, calcium phosphate, calcium phosphate ceramics or polymethyl methacrylate) and of different bone grafts (cancellous vs. cortical), and (3) the use of antibiotic-loading of bone graft substitutes in orthopedic surgery in Germany. Gross data were provided from the Federal Statistical Office of Germany and revealed an overall increase in bone defect reconstruction procedures using bone graft substitutes, autografts and allografts from 86,294 in 2008 to 99,863 cases in 2018 (+15.7%). The relative use of bone graft substitutes for these interventions strongly increased from 11.8% in 2008 (10,163 cases) to 23.9% in 2018 (23,838 cases) with an increase of +134.4%. Furthermore, antibiotic-loaded bone graft substitutes were implanted more frequently with an overall increase of +194% (2008: n=2,657; 2018: n=7,811). The work shows an increasing use of bone graft substitutes and antibiotic-loaded bone graft substitutes over the last 10 years in Germany.

Comparative study between two types of bone graft in dental implant

ABSTRACT: Introduction osseointegration around dental implant is the key word of implant stability and bone grafts have a big share for enhancing osseointegration . Aim of the study: To evaluate the efficacy of two different types of bone graft, the (OsteonII) and (Biogen). Patients and methods: This study was carried out on fifteen healthy male patientswith averageage from 20 to 40 years old.. 15 immediate dental implants were dividedinto (group1)immediate placement of 6 dental implant into fresh extracted bony socket with bone graft OsteonII,(group 2) immediate placement of 6 dental implant with bone graft BioGen and in, (group 3)immediate placement of 3dental implant into fresh extracted bony socket without bone graft.Clinical examination was donefor all patients befor surgery. Radiographic evaluation using CBCT was done after 2weeks and 3, 6 months postoperatively to measure bone density around inserted implants and vertical bone loss. Results: Radiographic evaluation showed significant higher bone density and lesser vertical bone loss around the inserted implants in groupII than groupI after two weeks, 6 and 9 months. Also, implant stability measurements at six and nine months showed higher values in group II than in group I. 4 / 21 Conclusion: immediate implant placement can be done successfully using either OsteonII or BioGen bone grafts but, BioGenare superior with using immediate dental implant than OsteonII regarding bone density and implant stability around implant. Key words:Alloplastic bone grafts-Immidiate placement-CBCT–Implant stability.

Primary stability of a press-fit cup in combination with impaction grafting in an acetabular defect model.

The objectives of this study were to (a) assess primary stability of a press-fit cup in a simplified acetabular defect model, filled with compacted cancellous bone chips, and (b) to compare the results with primary stability of a press-fit cup combined with two different types of bone graft substitute in the same defect model. A previously developed acetabular test model made of polyurethane foam was used, in which a mainly medial contained defect was implemented. Three test groups (N = 6 each) were prepared: Cancellous bone chips (bone chips), tricalciumphosphate tetrapods + collagen matrix (tetrapods + coll), bioactive glass S53P4 + polyethylene glycol-glycerol matrix (b.a.glass + PEG). Each material was compacted into the acetabulum and a press-fit cup was implanted. The specimens were loaded dynamically in the direction of the maximum resultant force during level walking. Relative motion between cup and test model was assessed with an optical measurement system. At the last load step (3000 N), inducible displacement was highest for bone chips with median [25th percentile; 75th percentile] value of 113 [110; 114] µm and lowest for b.a.glass + PEG with 91 [89; 93] µm. Migration at this load step was highest for b.a.glass + PEG with 868 [845; 936] µm and lowest for tetrapods + coll with 491 [487; 497] µm. The results show a comparable behavior under load of tetrapods + coll and bone chips and suggest that tetrapods + coll could be an attractive alternative to bone chips. However, so far, this was found for one specific defect type and primary stability should be further investigated in additional/more severe defects.

Efficacy and safety of maxillary sinus lifting with various types of grafting with implants insertion purposes: A review of the literature

Context: Edentulous patients under the use of removable prosthesis face important restrictions, including sociocultural ones and, for this reason, the insertion of implants has become frequent in clinical dental practice. However, the success of the method will depend on the sort of different types of bone grafting, quality of donor area and the residual amount of bone left in insertion site. Purpose: the purpose of this study was to evaluate the effectiveness and safety of different types of bone grafts used in maxillary sinus lifting surgeries for implant insertion. Methods: systematic review of randomized clinical trials or quasi-randomized. We used the guidelines of the manual of systematic reviews from Cochrane Collaboration and a sensitive search strategy in three electronic databases has been built. Results: We included six randomized clinical trials from different regions of the world with 135 participants. Bone volume was 3% higher on the grafted site with autogenic bone pure, but not a statistically significant difference DM: 3 (-8.48-14.48), the average percentage between the vital and non-vital bone showed up 0.82% higher on the grafted site with FDBA + PRP. The average percentage of vital tissue was also 15.8% higher on the side where PRP was used. Conclusion: the available evidence is insufficient to recommend a specific type of bone grafting in sinus augmentation (lift) procedures to place a dental implant. There was no statistically significant difference for bone volume, sensory loss, local inflammatory response and loss of implants, among others. For this reason, new randomized controlled trials that evaluate the effectiveness and safety of different types of bone graft for lifting of the maxillary sinus are necessary. Key-words: Maxillary sinus. Grafting, survey, technique, materials.

Bone defects substitution in total knee replacement (literature review)

The number of primary and revision total knee arthroplasties is continuously increasing. Presence of bone defects is one of the challenging issues for these surgeries that affects significantly treatment results and increases expenses.Objective: to analyze methods of preoperative and intraoperative diagnostics of knee joint articulating surfaces bone defects and existing classifications according to their advantages and disadvantages, to substantiate the treatment strategy for cases with various types of bone defects. Methods: articles from PubMed, EBSCO and Google Scholar data bases were used for scientific review.Results: the main negative factors affecting the stability of prosthesis components are the size and the shape of bone defect, presence or absence of cortical layer, quality of bone tissue, as well as implant design and correct choice of material and technique for filling of the defect. Evaluation of materials of natural origin — different types of bone grafts and artificial augments made of metals and polymeric materials was performed. Methods of bone grafts preparation and their fixation are important for different types of bone defects. In more complicated cases individual guides and resection blocks, virtual prototyping technologies and 3D-printing should be used for individual manufacturing of endoprosthesis.Conclusions: Usage of modern materials and techniques for filling of bone defects in total knee arthroplasties requires precise preoperative planing and choice of proper technique. Structural or morselized bone allografts, bone cement alone or in combination with screws and meshes, metal or polymeric augments of various shapes should be used for small bone defects, depending from their type, but large bone defects require stems and individually produced oncological and hinge implants.

Laboratory Monitoring of Bone Tissue Remodeling after Augmentation of Impression Intraarticular Fracture with Different Types of Bone Graft.

The effects of bone graft materials on the inflammatory response and biochemical markers of bone remodeling were studied on a rabbit model of fracture augmentation with the following grafts: β-tricalcium phosphate, demineralized bone matrix, nanostructured carbon implant, and porous titanium implant made by additive 3D printing. The markers of bone remodeling and the blood system response in the postoperative period were studied. It was found that porous titanium implant and β-tricalcium phosphate induced osteogenesis and minimized osteoclastic resorption. Augmentation with nanostructured carbon implant and demineralized bone matrix stimulated the processes of osteoclastic resorption.

Reoperation for Symptomatic Nonunions in Atlantoaxial (C1-C2) Fusions with and without Bone Morphogenetic Protein: A Cohort of 108 Patients with >2 Years Follow-Up

To determine if there is a difference in reoperation rates for symptomatic nonunions in atlantoaxial (C1-C2) fusions with or without bone morphogenetic protein (BMP) using data from a national spine registry and to analyze the different types of bone grafts used in the non-BMP group. Data from the Kaiser Permanente spine registry were used to identify patients with C1-C2 fusions with >2 years follow-up. Patient characteristics, diagnosis, operative times, length of stay, and reoperations were extracted from the registry. The data set was divided into patients with and without BMP. Further analysis was made of the different types of non-BMP grafts as well as the instrumentation used. In our cohort, we found 58 patients (53.7%) with BMP and 50 patients (46.3%) without with an average follow-up time of 5 years (interquartile range, 2.04-8.49). The BMP versus non-BMP groups differed in admitting diagnosis, operative times, length of stay, and follow-up times. There were no reoperations for symptomatic nonunions in both groups. The non-BMP group included iliac crest graft (with or without allograft [+/-] allograft); lamina (+/- allograft); and allograft alone. Using one of the largest retrospective studies on C1-C2 fusions with and without BMP, we found no difference in reoperation rates for symptomatic nonunions. For the non-BMP group, we found that lamina (+/- allograft) or allograft alone may also be just as effective as iliac crest graft (+/- allograft) in having no reoperations for symptomatic nonunions.

Lumbar fusion for lytic spondylolisthesis: Is an interbody cage necessary?

Study Design:This study was a retrospective observational study.Purpose:The purpose of the study was to determine the radiological and clinical outcome of using locally sourced autologous bone graft in the surgical management of single-level lumbar lytic spondylolisthesis.Background:Many spinal surgeons supplement pedicle screw fixation of lumbar spondylolisthesis with cages. In developing countries, the high cost of interbody cages has precluded their use, with surgeons resorting to filling the interbody space with different types of bone graft instead. This study reports on the clinical and radiological outcome of posterior lumbar interbody fusions for low-grade lytic spondylolisthesis using locally sourced autologous bone graft.Material and Methods:Posterior interbody fusion was performed in 22 consecutive patients over 18-month period, using (BRAND) pedicle screw system and locally sourced bone graft, i.e., bone removed during neural decompression. There were no postoperative restrictions, and all patients underwent clinical outcome measurements using Oswestry Disability Index (ODI), visual analogue pain score (VAS) at a minimum follow-up of 12 months, and computed tomography (CT) assessment of fusion with intraobserver validation by radiology consultant blinded, at 6 and12 months. Nearly 50% of the population were smokers.Results:There was significant clinical improvement in ODI, VAS back pain, and VAS leg pain (P < 0.001). By contrast, the radiologic fusion rate measured by CT at 12 months was less satisfactory at 64%. There was no difference in clinical outcome between the fused group and nonfused population.Conclusions:These results indicate that the use of locally sourced bone graft in single-level lumbar lytic low-grade spondylolisthesis. Interbody fusion provides good clinical outcomes. The use of an interbody cage may not be clinically necessary. Our radiologic outcome, however, shows inferior fusion rates compared with published data. Future research will focus on long-term outcomes

Guided bone regeneration with recombinant human bone morphogenetic protein 9 loaded on either deproteinized bovine bone mineral or a collagen barrier membrane.

Recombinant human bone morphogenetic protein 9 (rhBMP9) has been considered the most osteoinductive growth factor of the BMP-family and has much translation potential for guided bone regeneration (GBR) procedures. The aim of this study was to compare bone formation using rhBMP9 loaded with different carrier systems including deprotenized bovine bone mineral (BioOss, BO) or collagen barrier membranes (BioGide, BG) in a rabbit GBR model. rhBMP9 was loaded either on BO; named BO/BMP9, or BG; named BG/BMP9 to investigate the better carrier system for rhBMP9. New bone formation was quantified in a rabbit calvarial defect model using four groups; (1) control (empty, n = 9), (2) BO + BG (n = 9), (3) BO/BMP9 + BG (n = 9; BMP9 loaded onto BO), and (4) BO + BG/BMP9 (n = 9; BMP9 loaded onto BG) by radiographically and histologically at 8 weeks post-surgery. Both BO/BMP9 + BG and BO + BG/BMP9 samples significantly promoted new bone formation when compared to BO + BG samples based on parameters including mineralized tissue volume by microCT analysis, as well as new bone height and new bone area by histomorphometry. Interestingly, BO + BG/BMP9 samples but not BO/BMP9 + BG achieved near perfect horizontal bone defect closure, while demonstrating new bone layers in the defect areas implanted with BG materials and bone formation around BO materials. Both BO and BG positively induced bone formation with rhBMP9 in an experimental rabbit GBR model when compared to BO + BG alone. This study revealed that BG-loaded with rhBMP9 promoted better wound closure when compared to BO-loaded with rhBMP9. GBR procedures with growth factors may thus benefit from loading rhBMP9 onto BG-collagen barrier membranes when compared to BO-bone grafting particles. Future large animal studies with different types of bone grafts and barrier membranes are needed to further investigate these trends.

30 - Lumbar fusion for lytic spondylolisthesis: is an interbody cage necessary?

BACKGROUND CONTEXT: Many spinal surgeons routinely supplement pedicle screw fixation of lumbar spondylolisthesis with one or two cages. In developing countries, however, the high cost of interbody cages has precluded their use, with surgeons resorting to filling the interbody space with different types of bone graft instead. This retrospective study reports on the clinical and CT outcome of posterior lumbar interbody fusions (PLIF) for low-grade lytic spondylolisthesis using locally-sourced autologous bone graft.

Bone grafts utilized in dentistry: an analysis of patients' preferences.

BackgroundMany procedures currently require the use of bone grafts to replace or recover bone volume that has been resorbed. However, the patient’s opinion and preferences must be taken into account before implementing any treatment. Researchers have focused primarily on assessing the effectiveness of bone grafts rather than on patients' perceptions. Thus, the aim of this study was to explore patients' opinions regarding the different types of bone grafts used in dental treatments.MethodsOne hundred patients were randomly chosen participated in the study. A standardized survey of 10 questions was used to investigate their opinions regarding the different types of bone grafts used in dental treatments. Descriptive statistics were calculated for the different variables, and absolute frequencies and percentages were used as summary measures. A value of p <0.05 was selected as the threshold for statistical significance.ResultsThe highest rate of refusal was observed for allografts and xenografts. The grafts with the lowest rates of refusal were autologous grafts (3 %) and alloplastics (2 %). No significant differences were found between the various types of bone grafts in the sociodemographic variables or the refusal/acceptance variable. Similarly, no significant relations were observed between a specific religious affiliation and the acceptance/refusal rates of the various types of graft.ConclusionsAllografts and xenografts elicited the highest refusal rates among the surveyed patients, and autologous bone and alloplastics were the most accepted bone grafts. Moreover, no differences were found in the sociodemographic variables or religious affiliations in terms of the acceptance/refusal rates of the different bone grafts.

Surgical fixation methods for tibial plateau fractures.

Surgical fixation methods for tibial plateau fractures.

Preservation Technique of Autologous Bone in Scoliosis Surgery

Study Design This is a retrospective study. Objective This study aims to describe surgical technique of locally wound autologous bone conservation when primary surgery becomes mandatory to be staged, described as well the evolution and technique complications. Introduction One of the goals of scoliosis surgery is to halt the progression of curves achieving solid fusion. The contribution of additional bone graft in particular cases is critical. There are different types of bone grafts or bone substitutes, with different costs, and technical complications; it has become increasingly important the way to obtain and preserve a good amount of autologous bone. Patients and Methods A total of 12 patients, who required two-staged surgical procedures, were operated from June 2012 to April 2014 in our Spine Department. A subfascial pocket was performed in paraspinal muscles at the distal end of the surgical field where we added 1 g of vancomycin every 50 mL of bone graft. Surgical procedure, surgical correction, and complications with a full detailed analysis of infectious complications were assessed and recorded. Results Overall, 12 patients were operated in our hospital Spine Department with a two-staged surgical procedure plan. Patients mean age at surgery was 14 years. The etiology of deformity consisted in five idiopathic scoliosis, three congenital scoliosis, one associated with high-grade spondylolisthesis, two neuropathic scoliosis, and one myopathic scoliosis. In five cases (41.6%), surgery was initially staged in two different surgical days according to surgeon criteria and spinal severity deformity, in the other seven cases (58.4 degrees), the surgeon in charge, resolved to reschedule the surgical procedure in two different stages because of some intraoperative urgent event. The mean preoperative scoliosis angular value was 92.8 degrees. The mean postoperative scoliosis angular value was 42.4 degrees. We found that every patient in this study group required three surgical procedures to solved spinal deformity. Five patients developed superficial or deep infection (41.6%). Conclusion The local conservation of autologous bone graft in severe scoliosis surgery that has to be rescheduled or was already staged in 2 different days can be performed by storing the local bone graft in a subaponeurotic or subfascial pocket, with proper bone fusion imaging recordings, without incurring in an increasing risk of infection diminishing health costs.