Fresh-frozen Bone Research Articles

Corticocancellous fresh-frozen allograft bone blocks for augmenting atrophied posterior mandibles in humans.

Allograft fresh-frozen bone (FFB) is an alternative to autogenous bone for oral implantation due to bone quantity availability and lower morbidity for patients. Few specific studies about the use of FFB for reconstructing the posterior mandibular alveolar crest have been conducted. The objective of this study was to evaluate histological, histomorphometrical, and volumetric aspects of FFB allografts used to augment atrophied posterior mandible bone ridges. Sixteen hemi-mandibles of twelve patients presenting with critical alveolar atrophy were three-dimensionally reconstructed using corticocancellous FFB. Thirty blocks were fixed with titanium screws and covered with particulate bovine bone mineral and collagen membrane. Volumetric data were obtained by cone beam computed tomography analysis after 6months, implants were inserted, and bone biopsies were harvested and sent for histological and histomorphometric analyses. The blocks were distributed between nine female and three male patients (mean age, 50.9±8.3years). Thirty implants were installed, and the implant survival rate was 96.66%. Histology demonstrated newly formed vital bone contacting residual acellular allograft bone and connective tissue. The histomorphometric analysis showed 18.9±8.1% newly formed bone and 32.5±14.8% allograft residual bone. Graft absorption was 45% for height and volume, and both measures were significantly different (P<0.001). Fresh-frozen allografts are a viable alternative for reconstructing an atrophied mandible in the posterior region, allowing for new bone formation, installation of implants, and prosthetic loading.

Fresh-frozen allografts combined with bovine bone mineral enhance bone formation in sinus augmentation.

We evaluated histologically, histomorphometrically, and tomographically the effects of the association of fresh-frozen bone allograft (FFB) with bovine bone mineral (BBM) in maxillary sinus floor augmentation. In total, 34 maxillary sinuses from 29 patients, with a mean age of 51.32 (±6.44) years, underwent sinus augmentation. Patients were divided into control and test groups (17 sinuses each). The controls were grafted with allograft bone, and the test group received a combination of FFB and BBM at a 2:1 ratio. After 6 months, bone samples were collected for histological and histomorphometric examinations. The implant survival rates were 93.02% (control group) and 100% (test group) at 6 months after functional loading. Median volumetric reductions of 28.32% (17.05-44.05) and 12.62% (5.65-16.87) were observed for the control and test groups, respectively. Statistically significant histomorphometric differences were found between the control and test groups regarding newly formed bone 12.54% (10.50-13.33) vs. 24.42% (17.62-35.92), p < 0.001, total bone 48.34% (39.03-54.42) vs. 61.32% (50.61-64.96), p = 0.007, and connective tissue 51.66% (45.57-60.97) vs. 39.30% (35.03-49.37), p = 0.007. The addition of BBM to allograft bone in maxillary sinus augmentation resulted in higher percentages of new bone formation and total bone, and permitted implant placement with a low rate of osseointegration failure at the 6-month follow-up.

Clinical and Histomorphometric Evaluation of Fresh Frozen Bone Allograft in Sinus Lift Surgery.

The aim of this prospective clinical study was to evaluate the clinical and histomorphometric data of newly formed bone tissue from fresh frozen human allograft in sinus lift surgery. Thirty-three sinus lift procedures were performed in 20 patients, divided into two groups. The control group (n = 8) received autogenous bone from the mandibular ramus, and the experimental group (n = 12) received fresh frozen bone (FFB) allograft in chips. After 6 months, 52 implants were placed and 50 biopsies were collected for histomorphometric analysis. Cone beam computed tomography scans were performed at preoperative, immediate postoperative, and delayed postoperative time intervals to assess the degree of graft volume loss. There was no statistically significant difference between groups as regards degree of graft volume loss (p = .983), total bone area (p = .191), remaining particles (p = .348), and proportion of active osteoblasts (p = .867). There was a statistically significant difference in the vitality rate between the groups (p = .043). In both groups, all implants were clinically osseointegrated after 4 months. FFB allograft was shown to be a feasible substitute for autogenous bone graft in sinus lift surgery.

Magnetically driven middle ear ossicles with laser vibrometry as a new diagnostic tool to quantify ossicular fixation

Conclusion: Information on the degree of incus fixation can be gathered by measuring the ratio of incus to umbo long process velocity through the ear canal. Objectives: To test a new method of quantifying partial ossicular fixation in an ear with an elevated tympanic membrane. Methods: Measurements were made on four fresh-frozen human temporal bones. After elevating the tympanic membrane a small magnet was attached to the manubrium and an electromagnetic excitation coil was used to vibrate the ossicles. The vibration response of the tip of the incus long process and the umbo were measured before and after artificially fixating the incus to the lateral attic wall. Results: Partial incus fixation resulted in a decrease in both the incus and umbo velocities, with the incus velocity being more severely reduced. The decreased ratio of their vibrations is a clear indicator of the degree of incus fixation.

Correlation between density and resorption of fresh-frozen and autogenous bone grafts.

Trial Design. This analysis compared the outcome of fresh-frozen versus autologous bone block grafts for horizontal ridge augmentation in patients with Cawood and Howell class IV atrophies. Methods. Seventeen patients received autologous grafts and 21 patients received fresh-frozen bone grafts. Patients underwent CT scans 1 week and 6 months after surgery for graft volume and density analysis. Results. Two autologous and 3 fresh-frozen grafts failed. Autologous and fresh-frozen grafts lost, respectively, 28% and 46% of their initial volume (P = 0.028). It is noteworthy that less dense fresh-frozen blocks lost more volume than denser grafts (61% versus 16%). Conclusions. According to these 6-month results, only denser fresh-frozen bone graft may be an acceptable alternative to autologous bone for horizontal ridge augmentation. Further studies are needed to investigate its behaviour at longer time points.

The Fresh Frozen Bone Allograft (FFBA) to Reconstruct the Atrophic Maxilla: Evaluation of the Clinical and Histological Viability at Six and Nine Months in the Maxillary Sinus

Universidade Estadual Paulista Julio de Mesquita Filho, Faculdade de Odontologia de Aracatuba, R. Jose Bonifacio, 1193, Vila Mendonca, CEP 16015-050, SP, Brasil

Time-Dependent Changes in Fresh-Frozen Bone Block Grafts: Tomographic, Histologic, and Histomorphometric Findings

Bone allografts have shown satisfactory clinical results in alveolar ridge reconstructions. However, the process of incorporation and the resorption rates of these grafts are not yet fully understood. The aim of this study was to use computed tomography (CT), histology, and histomorphometry to assess the time-dependent rates of resorption and incorporation of fresh-frozen bone allografts. Twenty-four patients underwent alveolar ridge reconstruction with bone block allografts and were randomly allocated to three groups with different graft healing periods (4, 6, or 8 months) before implant placement. To assess the resorption rates, CT scans were acquired within 7 days after bone graft surgery and at the end of the period. Graft samples were collected and sent for histological and histomorphometric analyses. The graft resorption mean rates were 50.78% ± 10.43, 32.77% ± 7.84, and 13.02% ± 3.86 for the 4-, 6-, and 8-month groups, respectively, and were significantly different among the three groups. Newly formed bone with osteocytes near the grafted bone was observed in all three groups. The number of osteocytes was significantly lower at 4 months. Grafted bone remains were significantly higher in the shortest period of time. All of the grafts showed large amounts of calcified tissue. All three groups showed new bone formation and different bone resorption rates. Graft healing periods of 4 months showed less graft resorption and seemed to be the most favorable for implant placement. Healing periods of 8 months showed the largest rate of graft resorption, which could render the grafts unfavorable for implant placement.

Histological Evaluation of Fresh Frozen Bone Integration at Different Experimental Times

The aim of this work was to investigate, through histological evaluation, the in vivo behavior of fresh frozen bone (FFB) used as particulate bone substitute in intraoral regenerative procedures. A total of 10 patients (group 1) received particulate FFB graft for bone regeneration in postextractive sockets, and 10 (group 2) underwent maxillary sinus augmentation by using the same bone substitute as filling. Fresh frozen bone was supplied from the Tissue Bank of the Veneto Region, Treviso Section.Healing was uneventful for all the patients and was monitored by periodical radiographs. Patients were scheduled for implant insertion according to the radiographic aspect. However, the mean healing time for group 1 was 45 days, whereas for group 2 patients, it was 100 days. At the moment of implant insertion, bone specimens were collected at the site of implant placement, from both groups and processed for histological analysis.Histological analysis after hematoxylin-eosin staining obtained from group 1 patients showed the presence of newly formed bone tissue, still well distinguishable from the grafted bone substitute. In samples from group 2 patients, a better integration could be recognized associated with active bone remodeling phenomena.These results showed a good integration of the considered FFB graft within the host tissue both at 45 and 100 days after grafting, displaying this biomaterial as suitable for preimplant regenerative procedures.

Histomorphometrical Evaluation of Fresh Frozen Bone Allografts for Alveolar Bone Reconstruction: Preliminary Cases Comparing Femoral Head with Iliac Crest Grafts

In the past few years, the use of fresh frozen bone (FFB) grafts has significantly increased. The aim of this study was to evaluate the reconstruction of alveolar bone using femoral head and iliac crest FFB grafts. The study included 10 patients who need endosseous implant insertion in severe atrophic maxillae. The patients were treated with FFB grafts collected from the femoral head or iliac crest. Bone regeneration was evaluated 6 months after surgery by macroscopic and microscopic analyses. Our results showed good regenerative capacity, both with the FFB from the femoral head and iliac crest. In particular, similar percentages of new-bone formation and graft residual were observed, whereas differences between the percentage of total bone (higher for the iliac crest) and the percentage of non-mineralized tissue (higher for the femoral head) were present. A significantly higher percentage of CD34-positive vessels in the FFB allograft from the femoral head than in the iliac crest were observed. These findings suggest that FFB allografts could represent a reliable option in oral and maxillofacial surgery. Nevertheless, differences between the use of femoral head or iliac crest bone allografts linked with their different structures should be considered for a more effective surgery.

In This Issue of JAMA Facial Plastic Surgery

JAMA Facial Plastic SurgeryVol. 15, No. 1 Free AccessIn This Issue of JAMA Facial Plastic SurgeryPublished Online:1 Jan 2013AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail Nasal Tip Recontouring in Primary Rhinoplasty: The Endonasal Complete Release ApproachHolger G. Gassner, MD, and colleagues describe their approach to the nasal tip and lateral crus of the lower lateral cartilage, which they term the “endonasal complete release approach.” The authors precisely describe their technique and its application to various nasal tip deformities. A retrospective review of 100 consecutive patients undergoing septorhinoplasty in which the authors' technique was used is included, with particular emphasis on patient satisfaction. The authors discuss the advantages and disadvantages of their technique and potential limitations.See page 11Sliding Genioplasty Using Fresh-Frozen Bone AllograftsDario Bertossi, MD, and colleagues report their experience using fresh-frozen human bone allografts as interpositional grafts during sliding genioplasty in 10 patients. The authors present preoperative and postoperative cephalograms and computed tomographic scans in 10 patients and were able to obtain bone biopsy specimens to investigate integration in 1 patient. The authors' technique is described, compared, and contrasted with other methods of sliding genioplasty.See page 51Dry Eye Symptoms and Chemosis Following Blepharoplasty: A 10-Year Retrospective Review of 892 Cases in a Single-Surgeon SeriesJess Pirschman, MD, and colleagues conducted a retrospective medical chart review of all patients undergoing upper and/or lower blepharoplasty over a 10-year period to determine the incidence of dry eye following upper and/or lower blepharoplasty. Multiple risk factors for the development of dry eye following blepharoplasty are identified. The authors also report the incidence of chemosis following blepharoplasty and discuss possible causative factors.See page 39Sulcus Construction in Microtia Repair: A Retrospective Comparison of Different TechniquesShay I. Duvedani, MD, and colleagues performed a retrospective review of 3 different approaches to the creation of a postauricular sulcus in microtia reconstruction in 443 consecutive patients over a 14-year period. Techniques included in the study included the temporal parietal fascial flap, anteriorly based mastoid fascial flap, and a superficial musculoaponeurotic system flap. The authors measured the projection of the reconstructed ear achieved with each technique. The advantages and disadvantages of each technique are discussed, along with the authors' recommendations for the optimal technique.See page 17Deposition of Christ by Michelangelo Buonarroti (1475-1564).See page 68In This Issue was written by Cody Alan Koch, MD, PhD.FiguresReferencesRelatedDetails Volume 15Issue 1Jan 2013 InformationCopyright 2013 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.To cite this article:In This Issue of JAMA Facial Plastic Surgery.JAMA Facial Plastic Surgery.Jan 2013.7-7.http://doi.org/10.1001/jamafacial.2013.935Published in Volume: 15 Issue 1: January 1, 2013PDF download

Sliding Genioplasty Using Fresh-Frozen Bone Allografts

OBJECTIVE To present our experience in the use of fresh-frozen human bone allograft as an interpositional grafting material for sliding genioplasty to correct chin deformities. METHODS Ten patients underwent sliding genioplasty using morcellized and corticospongious fresh-frozen human bone. Four patients underwent orthognathic surgery associated with genioplasty. Six patient underwent genioplasty associated with rhinoplasty. Panorex, lateral, and frontal cephalogram and computed tomographic scans have been performed for each case preoperatively and 12 months after surgery. One patient subsequently asked for plate removal, and with his consent, a bone biopsy specimen was obtained during the operation. RESULTS Stable aesthetic and functional results were observed in all cases. No infections occurred, and no bone resorption has been clinically or radiologically observed. CONCLUSION The use of fresh-frozen bone allograft reduces patient morbidity and operative time, providing a stable and excellent aesthetic result.

Reconstruction of the edentulous mandible with fresh frozen bone grafts and implants: a 4-year report of a prospective clinical study

Allogen bones from tissue bank are often used in dentistry although the data analyzing the long-term success in mandible are scarce. This study evaluated by computed tomography scans (CTS) the bone resorption around the implants installed on fresh frozen bone (FFB) previously grafted, after 4 years of occlusal rehabilitation. Six subjects were grafted with blocks in posterior mandible using FFB. After 6 months, 27 implants were placed and after further 4 months the prostheses were delivered. Following 4 years of the final rehabilitation procedures, another CTS was done in order to measure the resorption in periimplant bone crest at the proximal implant surfaces. It was observed a 100 % survival rate of the implants after 4 years of the fixture installation. The marginal bone resorption after 48 months was 2.82 ± 1.63 mm and no statistical significant difference was observed along the region where the implants were fixed when compared with the interimplantar space. In addition there was no significant correlation regarding the length of the implant used and the amount of marginal bone resorption. The conclusion is that grafted areas with FFB are suitable to implant installation in the posterior mandible.

Embalmed and fresh frozen human bones in orthopedic cadaveric studies: which bone is authentic and feasible?

Background and purpose The most frequently used bones for mechanical testing of orthopedic and trauma devices are fresh frozen cadaveric bones, embalmed cadaveric bones, and artificial composite bones. Even today, the comparability of these different bone types has not been established.Methods We tested fresh frozen and embalmed cadaveric femora that were similar concerning age, sex, bone mineral density, and stiffness. Artificial composite femora were used as a reference group. Testing parameters were pullout forces of cortex and cancellous screws, maximum load until failure, and type of fracture generated.Results Stiffness and type of fracture generated (Pauwels III) were similar for all 3 bone types (fresh frozen: 969 N/mm, 95% confidence interval (CI): 897–1,039; embalmed: 999 N/mm, CI: 875–1,121; composite: 946 N/mm, CI: 852–1,040). Furthermore, no significant differences were found between fresh frozen and embalmed femora concerning pullout forces of cancellous screws (fresh frozen: 654 N, CI: 471–836; embalmed: 595 N, CI: 365–823) and cortex screws (fresh frozen: 1,152 N, CI: 894–1,408; embalmed: 1,461 N, CI: 880–2,042), and axial load until failure (fresh frozen: 3,427 N, CI: 2,564–4290; embalmed: 3,603 N, CI: 2,898–4,306). The reference group showed statistically significantly different results for pullout forces of cancellous screws (2,344 N, CI: 2,068–2,620) and cortex screws (5,536 N, CI: 5,203–5,867) and for the axial load until failure (> 7,952 N).Interpretation Embalmed femur bones and fresh frozen bones had similar characteristics by mechanical testing. Thus, we suggest that embalmed human cadaveric bone is a good and safe option for mechanical testing of orthopedic and trauma devices.

Mandibular Reconstruction Using Fresh Frozen Bone Allograft After Conservative Enucleation of a Mandibular Odontogenic Myxoma

The purpose of this article was to report the clinical, radiographic, and histological findings about a case of a young woman affected by a mandibular odontogenic myxoma. Conservative tumor resection was followed by immediate reconstructive treatment using fresh-frozen human bone graft, instead of autologous bone graft, as material for bone regeneration. Odontogenic myxoma, according to the World Health Organization, is classified as a benign tumor of mesenchymal origin whether or not containing odontogenic epithelium. Radiological and histological examination of the lesion confirmed the presence of an odontogenic myxoma, which was 21.2 mm high and 47.6 mm long; the lesion underwent biopsy evaluation before enucleation. According to literature and with the aim of a patient free of disease, conservative enucleation of the lesion was performed. The residual bone defect was filled with fresh-frozen bone allograft. At 6 months after surgery, no evidence of major complications was observed; the computed tomography scan revealed effective bone regeneration through the grafted area. The use of fresh-frozen bone allograft, thanks to its osteoinductive and osteoconductive properties, may represent an optional choice for reconstruction of bone defects after jaw tumor removal.

Fresh‐Frozen Bone Blocks for Horizontal Ridge Augmentation in the Upper Maxilla: 6‐Month Outcomes of a Randomized Controlled Trial

This randomized controlled trial compared fresh-frozen versus autologous bone blocks for maxillary horizontal ridge augmentation in patients with Cawood and Howell class IV atrophies. Twenty-four patients were allocated to the autologous and fresh-frozen groups in a 1:1 ratio. Patients underwent computed tomography scans 1 week and 6 months after surgery for graft volume and density analysis. Doxycycline was administered at day 120 and day 150 to label new bone formation. Biopsy for histologic and histomorphometric analyses was performed at reentry for implant insertion, 6 months after grafting. Fresh-frozen grafts had lower density than autologous bone. Autologous and fresh-frozen grafts lost, respectively, 25% and 52% of their initial volume (p = .0041). Histology revealed the presence of newly formed bone within both graft types, but clear signs of inflammation were present in fresh-frozen blocks. According to these 6-month results, autologous bone blocks are preferable to fresh-frozen bone grafts.

Maxillary alveolar ridge reconstruction with monocortical fresh-frozen bone blocks: A clinical, histological and histomorphometric study

BackgroundThis investigation is a clinical and histological assessment of fresh-frozen bone use in the reconstruction of maxillary alveolar ridges. The study evaluates the effectiveness of this material as a bone filler prior the placement of dental implants. Patients and methodsSixteen patients with atrophic maxillary ridges underwent maxillary reconstruction with fresh-frozen tibial human block grafts prior to implant placement. Sampling procedures were carried out 4, 6 and 9months later when a bone core was removed from the grafts for histological and histomorphometric analysis. ResultsEighteen blocks were placed, and each patient received either 1 or 2 blocks. During the sampling procedures, all of the grafts were found to be firm in consistency, well-incorporated, and vascularized. A total of 34 implants were placed into the grafts with a minimum of 40-Newton-cm torque in all cases. The follow-up period ranged from 18 to 30months. No implants were lost. The histological analysis revealed vital bone with mature and compact osseous tissue surrounded by marrow spaces. ConclusionBone allografts can be used successfully as graft material for the treatment of maxillary ridge defects. This type of bone graft can be used safely in the areas of implant placement as a suitable alternative to autogenous grafts.

Severe Maxillary Atrophy Treatment With Le Fort I, Allografts, and Implant-Supported Prosthetic Rehabilitation

Recently, several authors have described that autologous and fresh-frozen bones are effective materials to correct jaw bone defects before endosseous implant positioning. The aim of this study was to report a multistep oral rehabilitation of severe atrophic maxilla by means of Le Fort I osteotomy for maxillary downward and forward repositioning, allografts, implant insertion, and prosthetic loading. Patients with severe maxillary atrophy underwent Le Fort I osteotomy associated to fresh-frozen interpositional bone allografts. At 7 months after reconstructive procedure, 2 biopsies for each patient have been taken, and in the same surgical procedure, endosseous implants were placed. Five months afterward, abutments were connected for the final prosthodontic restauration. Each patient was evaluated at 1-year follow-up after prosthetic loading. At 1-year follow-up after functional prosthetic loading, no infection of the allografts or implant failure has been reported. Clinical and radiologic follow-up showed no sign of bone resorption in all the osteotomic sites and in the grafted areas. Histological analysis showed evidence of allograft osteointegration and healing. Multistep oral rehabilitation of severe atrophic maxilla with Le Fort and interpositional bone allografts represents a reliable surgical technique. According to this clinical, radiologic, and histologic reports, interpositional fresh-frozen bone allograft seems to be a valuable material for grafting jaw as it is cheaper than other materials and is safe, and it avoids donor site, decreasing the morbidity of the treatment

Clinical Similarities and Histological Diversity Comparing Fresh Frozen Onlay Bone Blocks Allografts and Autografts in Human Maxillary Reconstruction

In the absence of autologous bone for harvesting, fresh-frozen bone allografts turned into an alternative for bone reconstruction procedures. The purpose of this study was to make a histological analysis of fresh-frozen onlay bone allografts (ALs), compared with autografts, in patients who needed maxillary reconstruction prior to dental implants placement. Twelve patients with bone deficiencies (width inferior to 4 mm) in the sites where the implants were planned were enrolled in the study. From these, six were elected to be treated with autogenous (AT) bone grafts and six with fresh-frozen bone AL. This last group included the patients who had absence of a convenient amount of bone in donor sites. Each patient received from one to six graft blocks, totalling to 12 ATs and 17 ALs. Seven months after grafting procedures, biopsies of the grafts were made using 2-mm internal diameter trephine burs, and processed for histological analysis. One biopsy was retrieved from each patient. Clinically, all grafts were found to be firm in consistency and well-incorporated to the receptor bed. Histological analysis showed a large amount of necrotic bone surrounded by few spots of new-formed bone in the AL group, suggesting low rate of graft remodeling. In the AT group, an advanced stage of bone remodeling was seen. Human fresh-frozen bone block AL showed clinical compatibility for grafting procedures, although associated to slow remodeling process. Further studies are needed to define, at long term, the remodeling process chronology the clinical longitudinal results for fresh-frozen bone AL.

Is Peripheral Blood Cell Balanced Altered by the Use of Fresh Frozen Bone Block Allografts in Lateral Maxillary Ridge Augmentation?

The relationship between the immune response and red and white blood cell homeostasis is cited in literature, but no studies regarding the balance of these cell populations following maxillary bone-graft surgeries can be found. The aim of this study was to evaluate the possible impairments in the blood cell balance following fresh-frozen allogeneic bone-graft augmentation procedures in patients who needed maxillary reconstruction prior to implants. From 33 patients elected to onlay bone grafting procedures, 20 were treated with fresh-frozen bone allografts and 13 with autologous bone grafts. Five blood samples were collected from each patient in a 6-month period (baseline: 14, 30, 90, and 180 days postsurgery), and the hematological parameters (erythrogram, leukogram, and platelets count) were accessed. All evaluated parameters were within the reference values accepted as normal, and significant differences were found for the eosinophils count when comparing the treatments (30 days, p = .035) and when comparing different periods of evaluation (allograft-treated group, baseline × 180 days, p ≤ .05 and 90 × 180 days, p ≤ .01; autograft-treated group, 30 × 90 days, p ≤ .05 and 30 × 180 days, p ≤ .05). Both autologous and fresh-frozen allogeneic bone grafts did not cause any impairment in the red and white blood cell balance, based on quantitative hemogram analysis, in patients subjected to maxillary reconstruction.

Can We Trust Ex Vivo Mechanical Testing of Fresh–Frozen Cadaveric Specimens? The Effect of Postfreezing Delays

Because embalming has been demonstrated to decrease the mechanical integrity of bone, most investigators favor fresh-frozen specimens for biomechanical evaluation. However, little is known about how the integrity of fresh--frozen specimens may change during biomechanical testing or may be affected by standard practices in testing. The purpose of this study was to evaluate how the time after removal from a freezer may affect the mechanical properties of fresh--frozen diaphyseal bone. Matched pairs of nonosteoporotic fresh--frozen human cadaveric femora were thawed before instrumentation with bicortical screws. Matched femora were reserved for either control or delayed use. Each specimen received standard diaphyseal bicortical screws (six or more in each group). At specified time points, screws were axially pulled out following the guidelines of ASTM F543-07. Test groups were stored in air (21 ± 0.5°C) for 16, 50, or 90 hours. In the control group, screws were pulled out at 16 hours, which corresponds to the minimum elapsed time for specimen thawing, instrumentation, potting, and biomechanical test initiation. This represents the baseline mechanical properties of the fresh--frozen bone at the inception of any biomechanical test. The 90-hour group corresponds to the time needed to cycle a construct 300,000 times at a physiological test frequency of 1 Hz. This corresponds approximately to 2 to 4 months of in vivo loading. A midpoint of 50 hours was also tested, representing approximately 180,000 cycles. Failure for all specimens occurred as a result of bone failure at the screw-to-bone interface. There was a decrease in screw pullout strength as exposure time in air increased. The 50-hour test group showed a 9% decrease in screw pullout strength as compared with the 16-hour control group (P = 0.81). However, the 90-hour test group showed a 30% decrease in screw pullout strength as compared with the 16-hour control group (P = 0.04). This study indicates that when using fresh-frozen cadaveric bone in biomechanical tests to simulate the orthopaedic clinical setting, specimen exposure time should be considered. The timing of testing should be kept constant between specimens to allow for a proper comparison. Furthermore, for fresh--frozen cadavers, the physical properties of bone may be detrimentally affected in biomechanical testing that exceeds the 50-hour time point after removal from the freezer.