Type Of Bone Graft Research Articles

Patient-reported outcomes and comprehensive assessment of wrist function after scaphoid reconstruction: A single-center retrospective study on 162 patients

A vast body of literature emphasizes radiological data for assessing outcomes in scaphoid reconstruction. The goal of this single-center study was to examine patients' reported outcomes and wrist function after scaphoid reconstruction.162 of 370 patients who underwent scaphoid reconstruction between January 2007 and December 2020 were included. Analyses used R version 4.0.2 with a significance level at p=0.05.The clinical follow-up averaged 7.44 years (range 1.03-14.65), with 87% of patients achieving union. The average DASH score was 7.54 (±10.08). The range of motion (ROM) for extension/flexion (E/F) averaged 115.97° (±21.77°) and the grip strength 42.49kg (±10.78). No statistically significant differences in the parameters studied were observed regarding the occurrence of union. Subgroups of patients without avascular necrosis (AVN) and those with preoperative carpal misalignment and without carpal instability achieved better functional outcomes with non-vascularized bone grafts compared to vascularized grafts. K-wire fixation resulted in poorer functional outcomes in case of carpal instability, including ROM in E/F (p=0.02) and complete ROM (p=0.03), compared to stabilization with compression screw. In patients with AVN (N=27), neither the type of bone graft nor the osteosynthesis method had any significant effect on functional or patient-reported outcomes. Female patients reached a higher DASH score (p=0.03), ROM in E/F (p=0.04), ROM in ulnar/radial deviation (p=0.04), ROM in pronation/supination (p=0.02), and cROM (p= 0.01) than the male patients.More complex reconstruction methods may lead to inferior outcomes and should be reserved for specific indications. Better functional but worse patient-reported outcomes in female patients warrant further analysis.

Evaluation of grafts fixation techniques for temporomandibular joint reconstruction with medial femoral condyle flap: A numerical study

Reconstruction for large-scale temporomandibular joint (TMJ) defects can be challenging. Previously, we utilized the medial femoral condyle (MFC) flap for TMJ reconstruction. However, the optimal fixation method remains uncertain. In this study, finite element analysis was used to study the effects of three different fixation types of bone graft: overlap type, bevel type, and flush type. Models of different fixation types of MFC flap were reconstructed from CT images. A standard internal fixation model for extracapsular condylar fracture was also included as a control. Displacement of bone graft, deformation of plates and screws, and stress distribution of plates, screws, and cortical and cancellous of the bone graft were analyzed by finite element analysis to investigate their biomechanical features. The displacement of the bone graft and deformation of plates and screws in three different fixation types showed no significant difference. The overlap type and flush type of fixation displayed the lowest and highest stress respectively. All three fixation types could satisfy the mechanical requirement and face no risk of breakage and the major displacement of the MFC bone graft. These results provide insights into the optimal fixation approach for MFC bone grafts, offering valuable guidance and reference for clinical application.

Surgical fixation methods for tibial plateau fractures.

Tibial plateau fractures, which are intra-articular injuries of the knee joint, are often difficult to treat and have a high complication rate, including early-onset osteoarthritis. The most common treatment for complex tibial plateau fractures is surgical fixation. Additionally, orthopaedic surgeons often use bone defect fillers to address bone defects caused by the injury. Currently, there is no consensus on the best method of fixation and on whether bone defect fillers are necessary. To assess the benefits and harms of different surgical interventions and bone defect fillers for treating tibial plateau fractures. We searched CENTRAL, MEDLINE, Embase, and trial registries up to March 2023. We also searched conference proceedings and the grey literature. We included randomised controlled trials (RCTs) and quasi-RCTs comparing surgical interventions for treating tibial plateau fractures and different types of filler for bone defects. Two review authors independently screened search results, selected studies, extracted data, and assessed risk of bias. We calculated risk ratios (RRs) for dichotomous outcomes and mean differences (MDs) or standardised mean differences (SMDs) for continuous outcomes, with 95% confidence intervals (CIs). Our primary outcomes (and the specific measures we considered most relevant) were generic quality of life (general health score in the 36-item Short-Form Health Survey (SF-36)), patient-reported lower limb function (Hospital for Special Surgery (HSS) score), and adverse events (frequency of unplanned reoperation). We used GRADE to assess the certainty of evidence. We included 15 trials in the review, with a total of 948 adult participants. Nine trials compared different types of fixation, and six trials evaluated different types of bone graft substitutes. All 15 trials were small and at high risk of bias. We considered most available evidence to be of very low certainty, meaning we have very little confidence in the results. Only limited pooling was possible. One trial compared circular fixation combined with insertion of percutaneous screws (hybrid fixation) versus standard open reduction and internal fixation (ORIF) in 82 people with open or closed Schatzker types V or VI tibial plateau fractures. At 24 months' follow-up, hybrid fixation compared with ORIF may have little or no effect on SF-36 general health score (MD 6 points higher, 95% CI 7.7 points lower to 19.7 points higher; 66 participants), patient-reported lower limb function according to the HSS score (MD 7 points higher, 95% CI 2.4 points lower to 16.4 points higher; 66 participants), or frequency of unplanned reoperation (RR 0.78, 95% CI 0.45 to 1.32; 83 fractures (82 participants)). However, the evidence for all three outcomes is very uncertain. Three trials (with 242 participants) compared single-plating ORIF versus double-plating ORIF. There may be little to know difference in patient-reported lower limb function (HSS score) at 24 months' follow-up in people who undergo single-plating ORIF compared with those who undergo double-plating ORIF (MD 0.2 points higher, 95% CI 2.12 points lower to 2.52 points higher; 1 study, 84 participants), but the evidence is very uncertain. There were no data for quality of life or unplanned reoperation at 24 months' follow-up. Six trials (including 368 participants) compared bone substitute versus autologous bone graft (autograft) for managing bone defects. No trials reported SF-36 general health score, HSS score, or frequency of unplanned reoperation at 24 months' follow-up. There is insufficient evidence to ascertain the best method of fixation or the best method of addressing bone defects during surgery in people with tibial plateau fractures. Further well-designed RCTs with larger sample sizes are warranted.

Impact of Interproximal Features on Marginal Bone Level Changes of Autograft, Allograft, and Xenograft after Functional Loading: A Retrospective Study

Abstract Aim: This study aims to investigate the marginal bone level changes (MBLCs) concerning interproximal features of posterior implant-supported single crowns using different bone grafts. Materials and Methods: This retrospective study included 27 patients requiring 46 dental implants using autograft, allograft, or xenograft between January 2007 and December 2016. MBLCs were assessed using digital periapical radiographs at 3 months (T1), 12–15 months (T2), and 21–24 months (T3) after prosthesis delivery. The influence of interproximal features, such as embrasure surface area, emergence angle, and horizontal distance to adjacent teeth/implants, was assessed. Secondarily, age, gender, diabetes and smoking, arch distribution, implant locations, implant characteristics, average gonial angle, antagonist type, clinical crown-to-fixture ratio, retention method, and nearby tooth/implant were considered. Wilcoxon signed-rank test, Mann–Whitney U tests, and Kruskal–Wallis tests were employed with statistical significance set at a P value of <0.05. Results: The results revealed that mean MBLCs at T3–T1 were similar (autograft 0.5 ± 0.47 mm, allograft 0.51 ± 0.35 mm, and xenograft 0.57 ± 0.42 mm). There were significant increases in MBLCs associated with EA ≤ 30° in autograft (P = 0.04), and HD ≤ 3 mm in allograft (P = 0.03). Mesial/distal MBLCs showed no significant differences, except in cases with HD ≤ 3 mm in the distal area of autograft (P = 0.03). Regarding secondary factors, significant differences in MBLCs emerged between autograft and xenograft in the molar area (P = 0.03), and between premolar and molar areas within the xenograft group (P = 0.01). Conclusion: This study concludes that interproximal features, EA ≤ 30° and HD ≤ 3 mm, markedly influenced MBLCs for specific types of bone grafts. Furthermore, MBLCs exhibited a direct relationship with the posterior placement of dental implants.

Effect of mineralized dentin matrix on the prognosis of bone defect and retained root after coronectomy.

To investigate the impact of mineralized dentin matrix (MDM) on the prognosis on bone regeneration and migration of retained roots after coronectomy. Patients were divided into three groups based on the type of bone graft after coronectomy: Group C (n = 20, collagen), Group T (n = 20, tricalcium phosphate (TCP) + collagen), and Group D (n = 20, MDM + collagen). CBCT scans, conducted immediately and 6 months after surgery, were analyzed using digital software. Primary outcomes, including changes in bone defect depth and retained root migration distance, were evaluated 6 months after surgery. After 6 months, both Groups D and T exhibited greater reduction of the bone defect and lesser retained root migration than Group C (p < 0.001). Group D had greater regenerated bone volume in the distal 2mm (73 mm3 vs. 57 mm3, p = 0.011) and lesser root migration (2.18mm vs. 2.96mm, p < 0.001) than Group T. The proportion of completely bone embedded retained roots was also greater in Group D than in Group C (70.0% vs. 42.1%, p = 0.003). MDM is an appropriate graft material for improving bone defect healing and reducing retained root migration after coronectomy. MDM is an autogenous material prepared chairside, which can significantly improve bone healing and reduce the risk of retained root re-eruption. MDM holds promise as a routine bone substitute material after M3M coronectomy.

Transformable Carbonate Apatite Chains as a Novel Type of Bone Graft (Adv. Healthcare Mater. 12/2024)

Transformable Carbonate Apatite Chains as a Novel Type of Bone Graft (Adv. Healthcare Mater. 12/2024)

A comparative study of volar locking-plate fixation with corticocancellous and pure cancellous bone grafts for scaphoid nonunion with dorsal intercalated segmental instability secondary to scaphoid humpback deformity

IntroductionBone grafts for scaphoid nonunion with deformity include cortcicocancellous or pure cancellous bone grafts. This study compared the outcomes between two types of bone grafts when employing a volar locking-plate in patients with scaphoid nonunion with dorsal intercalated segmental instability (DISI). Patients and MethodsThis retrospective study included 34 patients with scaphoid nonunion and DISI due to humpback deformity treated between March 2017 and January 2022. Two types of bone grafts were obtained from iliac crest. Twenty of the corticocancellous (CC) group underwent a wedge-shaped graft, while 14 patients of the pure cancellous (C-only) group received graft chips. In both groups, a 1.5-mm anatomically pre-contoured locking plate was used for fixation. Radiographic evaluations included the union rate and carpal alignment including scapholunate angle (SLA), radiolunate angle (RLA), intrascaphoid angle (ISA) and scaphoid height to length ratio (HLR). Clinical assessments encompassed wrist range-of-motion, grip strength, and patient-reported outcomes. ResultsNineteen of the 20 patients in the CC group and 12 of the 14 patients in the C-only group respectively, achieving osseous union. The mean follow-up period in CC group was 14.7 (range, 12 ∼ 24) months and that in C-only group was 12.6 (range, 12 ∼ 15) months. Postoperatively, there were no significant intergroup differences of radiographic parameters including SLA (CC; 49.9° ± 6.7° vs. C-only; 48.9° ± 3.5°, P = 0.676), RLA (1.7° ± 6.4° vs. 2.4° ± 3.3°, P = 0.74), ISA (36° ± 7.5° vs. 36.6° ± 12.2°, P = 0.881), and HLR (0.54 ± 0.09 vs. 0.53 ± 0.05, P = 0.587). Clinical outcomes, including the flexion–extension arc (137° ± 30° vs. 158° ± 33°, P = 0.122), grip strength (93.4 % ± 15.4% vs. 99.5 % ± 16.7 %, P = 0.39), Quick Disabilities of the Arm, Shoulder, and Hand scores (11.2 ± 8.3 vs. 12.5 ± 7.7, P = 0.74) and Mayo Wrist Scores (81.2 ± 13.1 vs. 89 ± 11.4, P = 0.242) also showed no significant intergroup differences. ConclusionsVolar locking-plate fixation with pure cancellous bone grafts achieved outcomes comparable to those achieved with corticocancellous bone grafts in scaphoid nonunion with deformity, possibly due to the biomechanical advantages of the volar plate to provide structural supports.

Cranioplasty in Oman: Retrospective review of cases from the National Craniofacial Center 2012-2022.

Cranioplasty is a complex craniofacial and neurosurgical procedure that aims to reinstate the architecture of the cranial vault and elevate both its aesthetic and neurological function. Several reconstructive materials have been thoroughly explored in the search for the optimal solution for cranioplasty. This study aimed to evaluate different material used for cranial reconstruction in Oman. This retrospective study included all patients who had had cranioplasty procedures performed at Khoula Hospital, Muscat, Oman, from 2012 to 2022. Demographic information, the characteristics of the cranial defect and any complications that occurred post-operatively were analysed. A total of 47 patients were included in this study. The most common cause of cranial defects was craniectomy following traumatic head injury (70.2%) along with excision of fibrous dysplasia (10.6%). The most frequently utilised material for cranial repair was autologous bone grafts (n = 28), followed by polyetheretherketone (PEEK; n = 14). Interestingly, the replacement of bone grafts from previous craniectomy showed a notably high resorption rate (71.4%), in contrast to split calvarial grafts (0%) and other types of bone grafts (14.3%). Additionally, delayed graft infection was observed in 3.6% of the bone graft group and 7.1% of the PEEK group. Patient-specific alloplastic implants such as PEEK have gained popularity for large and complex cranioplasty, as they provide excellent aesthetic outcomes and leave no donor site morbidity. In contrast, bone grafts remain the gold standard for small to medium-sized cranial defects.

Does type of bone graft matter? A retrospective review of the use of biological bone grafts in patients undergoing elective 1-3 level spinal interbody fusion.

There is a lack of strong evidence for use of expensive bone substitutes. This study compares perioperative data and patient reported quality-of-life outcomes across the varied types of bone graft extenders. The study analyzes the existing Quality and Outcomes Database and evaluates patient reported outcomes for 1-3 level lumbar fusion procedures comparing across different types of biologics bone graft. We retrospectively analyzed a prospectively collected data registry. Bone graft implant data were collected and grouped into the following categories: (1) Autograft with basic allograft (2) Enhanced, synthetic, or cellular allograft (3) Use of BMP. Preoperative and 1year patient reported outcomes and perioperative data from the prospective collected registry were analyzed. There were 384 patients included in this study. There were 168 (43.8%) patients in group 1, 133 (34.6%) patients in group 2, and 83 (21.6%) in group 3. There were no group differences in baseline or 1year back pain, leg pain, ODI, or EQ-5D. The GLM Repeated Measures results indicate a significant difference within each of the three groups between the preoperative and postoperative measures for back pain, leg pain, ODI, and EQ-5D. The change over time was not significantly different between the groups. Bone graft extenders are a significant contributor to the cost of lumbar fusion. This study demonstrates no difference in preoperative, and 1year patient reported outcomes between the three groups. There was no significant difference in rate of reoperations across the three groups.

Long-term survival and success rate of dental implants placed in reconstructed areas with extraoral autogenous bone grafts: A systematic review and meta-analysis.

To evaluate the long-term survival and success rates of implants placed in reconstructed areas using microvascularized or non-microvascularized extraoral bone grafts. An electronic search was performed in five databases and in gray literature for articles published until June, 2023. The eligibility criteria comprised observational studies (prospective or retrospective) and clinical trials, reporting survival and success rates of implants placed in extraoral bone grafts. A meta-analysis (implant failure) was categorized into subgroups based on the type of bone graft used. The risk of bias within studies was assessed using the Newcastle-Ottawa Scale. Thirty-one studies met the inclusion criteria. The mean follow-up time was 92 months. The summary estimate of survival rate at the implant level were 94.9% (CI: 90.1%-97.4%) for non-vascularized iliac graft, 96.5% (CI: 91.4%-98.6%) for non-vascularized calvaria graft, and 92.3% (CI: 89.1%-94.6%) for vascularized fibula graft. The mean success rate and marginal bone loss (MBL) were 83.2%; 2.25 mm, 92.2%; 0.93 mm, and 87.6%; 1.49 mm, respectively. Implants placed in areas reconstructed using extraoral autogenous bone graft have high long-term survival rates and low long-term MBLs. The data did not demonstrate clinically relevant differences in the survival, success, or MBL of grafts from different donor areas or with different vascularization. This systematic review was registered in INPLASY under number INPLASY202390004.

Transformable Carbonate Apatite Chains as a Novel Type of Bone Graft.

The aging global population is generating an ever-increasing demand for bone regeneration. Various materials, including blocks, granules, and sponges, are developed for bone regeneration. However, blocks require troublesome shaping and exhibit poor bone-defect conformities; granules migrate into the surrounding tissues during and after filling of the defect, causing handling difficulties and complications; and sponges contain polymers that are subject to religious restrictions, lack osteoconductivity, and may cause inflammation and allergies. Herein, carbonate apatite chains that overcome the limitations of conventional materials are presented. Although carbonate apatite granules migrate, causing inflammation and ectopic calcification, the chains remain in the defects without causing any complications. The chains conform to the defect shape and transform into 3D porous structures, resulting in faster bone regeneration than that observed using granules. Thus, these findings indicate that even traditional calcium phosphates materials can be converted to state-of-the-art materials via shape control.

Advances in implants and bone graft types for lumbar spinal fusion surgery.

The increasing prevalence of spinal disorders worldwide necessitates advanced treatments, particularly interbody fusion for severe cases that are unresponsive to non-surgical interventions. This procedure, especially 360° lumbar interbody fusion, employs an interbody cage, pedicle screw-and-rod instrumentation, and autologous bone graft (ABG) to enhance spinal stability and promote fusion. Despite significant advancements, a persistent 10% incidence of non-union continues to result in compromised patient outcomes and escalated healthcare costs. Innovations in lumbar stabilisation seek to mimic the properties of natural bone, with evolving implant materials like titanium (Ti) and polyetheretherketone (PEEK) and their composites offering new prospects. Additionally, biomimetic cages featuring precisely engineered porosities and interconnectivity have gained traction, as they enhance osteogenic differentiation, support osteogenesis, and alleviate stress-shielding. However, the limitations of ABG, such as harvesting morbidities and limited fusion capacity, have spurred the exploration of sophisticated solutions involving advanced bone graft substitutes. Currently, demineralised bone matrix and ceramics are in clinical use, forming the basis for future investigations into novel bone graft substitutes. Bioglass, a promising newcomer, is under investigation despite its observed rapid absorption and the potential for foreign body reactions in preclinical studies. Its clinical applicability remains under scrutiny, with ongoing research addressing challenges related to burst release and appropriate dosing. Conversely, the well-documented favourable osteogenic potential of growth factors remains encouraging, with current efforts focused on modulating their release dynamics to minimise complications. In this evidence-based narrative review, we provide a comprehensive overview of the evolving landscape of non-degradable spinal implants and bone graft substitutes, emphasising their applications in lumbar spinal fusion surgery. We highlight the necessity for continued research to improve clinical outcomes and enhance patient well-being.

Prevalence Biological Complications in Patients with dental Implants for 10 years

Objective: To evaluate the prevalence of biological complications for 10 years in patients with dental implants by reviewing clinical reports (2012-2022) of the University Foundation UniCIEO. Method: Analytical retrospective study approved by the Ethics Committee as risk-free research. The clinical histories of selected the medical records of patients of the Oral Implantology Clinic University UniCIEO (2012 -2022), with report during the first 30 days of: age, gender, pre-existing diseases, habits, type of prophylaxis, type of surgery, implants and bone graft. Biological complications: pain, flushing, edema, tissue dehiscence and scarring. Descriptive statistics through analysis of contingency tables and inferential Chi- square test. Results: Total of medical records that met the inclusion criteria 229. Rango of age (26 - 82 years). Women 143 average age (54.9 years), men 86 average age (56.9 years). Presence of pre-existing diseases 122 patients (53.28%). Prophylaxis with amoxicillin 228 patients (99.5%), whit pain (2.62%), edema (4.80%), flushing (4.37%), suppuration (1.75%), tissue dehiscence (13.10%) for a total prevalence of biological complications of 26.64% with correct healing (86.46%). Bone grafts (51.97%), allograft (41,92%) y Xenograft (10,05%). the number of implants placed in the surgical procedure (1 – 13), the most frequent being 2/ procedure. The Chi-Square Test showed no significant association between the type of prophylaxis and the presence of each of the biological complications (p&gt;0.005). Conclusion: The prevalence of biological complications for 10 years in patients with dental implants use of Amoxicillin prophylaxis was low and tissue dehiscence was the most frequently with high percentage of correct healing.

Comparative Histomorphometric Analysis of Bone Regeneration According to Bone Graft Type

Comparative Histomorphometric Analysis of Bone Regeneration According to Bone Graft Type

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.

Postoperative scaphoid alignment, smoking, and avascular necrosis mostly influence union rate after scaphoid reconstruction: Results from a retrospective single center study involving 370 patients

Current literature does not definitely demonstrate the superiority of any particular scaphoid reconstruction method. The primary goal of this retrospective single center study was to evaluate the influence of reconstruction techniques and other factors on the union rate after reconstruction of scaphoid nonunions. In the study, 370 patients with nonunions classified as stable (Mayo 1) or unstable (Mayo 2) depending on carpal alignment were included. Minimal radiological follow-up was 3 months. Bone healing after scaphoid reconstruction was evaluated using computer tomography scans in 294 and radiograms in 76 patients. Univariate and multivariate logistic regressions were applied in the analysis. Eight statistically significant factors that influenced the union rate were fixation method, type of previous operations, number of all operations, number of reconstructions, smoking, postoperative pathological lateral intrascaphoid angle (LISA>45°), avascular necrosis (AVN), and stability of nonunion. Smoking and postoperative LISA>45° significantly reduced the probability of bone fusion by approximately 4.4 and 9.5 times, respectively. Patients with reduced vascularity in the nonunion site had a 5.2 times lower chance of bone fusion. Our multivariate logistic regression model can explain 32% of failures after scaphoid reconstruction, including postoperative LISA>45°, patients' present record of smoking, and reduced vascularity in the nonunion site. However, bone graft type does not impact the union rate in general; however, in case of AVN, the tendency toward higher union rates was observed for medial femoral condyle free flaps when compared to other types of graft (non-vascularized and pedicled bone grafts considered as one group, p=0.09).

Comparison of vertical bone resorption following various types of autologous block bone grafts

BackgroundThis study aims to measure and compare the differences in vertical bone resorption after vertical augmentation using different types of autologous block bone.MethodsData were collected from 38 patients who had undergone vertical ridge augmentation using an autologous block bone before implant insertion. The patients were divided into three groups based on the donor sites: ramus bone (RB), chin bone (CB), and iliac crestal bone (IB).ResultsThe surgical outcome of the augmentation was evaluated at the follow-up periods up to 60 months. In 38 patients, the mean amount of vertical bone gain was 8.36 ± 1.51 mm in the IB group, followed by the RB group (4.17 ± 1.31 mm) and the CB group (3.44 ± 1.08 mm). There is a significant difference in vertical bone resorption between the groups (p < 0.001), and the RB group demonstrated significantly lower resorption than the CB and IB groups (p = 0.011 and p < 0.001, respectively). The most common postoperative complications included neurosensory disturbance in the CB graft and gait disturbance in the IB graft. Out of the 92 implants inserted after augmentation, four implants were lost during the study period, resulting in an implant success rate of 95.65%.ConclusionsThe RB graft might be the most suitable option for vertical augmentation in terms of maintaining postoperative vertical height and reducing morbidity, although the initial gain was greater with the IB graft compared to other block bones.

Effectiveness of Two Differently Processed Bovine-Derived Xenografts for Alveolar Ridge Preservation with a Minimally Invasive Tooth Extraction Approach: A Feasibility Clinical Trial.

Xenogeneic-derived biomaterials are among the most routinely employed bone substitutes for immediate grafting of extraction sites as a modality of alveolar ridge preservation (ARP). The deproteinized bovine bone material is widely used and documented around the world. The present pilot clinical trial evaluated and compared the clinical and morphologic alterations of extraction sites after ARP using two commercially available yet differently processed bovine bone grafts. A total of 20 adjacent extraction sites in 10 patients were included. All sites received the exact same ARP therapy except for the type of bovine bone graft, which was randomly assigned between two adjacent extraction sockets in 10 patients (Group A received Bio-Oss particles and Group B received Cerabone particles). At all sites, healing was monitored at the time of surgery and at 1, 2, 3, and 4 months postoperative. All of the augmented extraction sites achieved successful implant therapy regardless of the bone graft material used for ARP. Six weeks after implant placement, second-stage/uncovering procedures were performed without complications. Intergroup comparisons of the crestal gingival healing process (CGHP), mean transversal crestal ridge resorption (MTRR), and mean implant primary stability (MIPS) were in favor of Group A sites (treatment with Bio-Oss particles).

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.

Outcomes of scapulothoracic fusion in patients with facioscapulohumeral dystrophy: a comparison of allograft versus autograft bone grafting.

Scapulothoracic (ST) fusion for facioscapulohumeral muscular dystrophy (FSHD) is an established treatment that corrects scapular instability, although it has high reported complication rates. The purpose of our study was to characterize the outcomes of ST fusion for FSHD in a large patient cohort and compare the outcomes based on bone graft type and fixation technique. Our hypothesis was that union rates would not differ by bone graft type during ST fusion. A retrospective chart review was undertaken to identify patients who underwent ST fusion at multiple institutions performed by a single surgeon between 2013 and 2019 with minimum 2-year follow-up. Patient demographic characteristics, surgical technique, time to union, complications, and clinical outcomes including patient-reported outcome measures were recorded. Univariate and multivariate statistical analyses including regression analyses were performed to compare preoperative and postoperative outcomes. A total of 50 patients with 54 ST fusions (bilateral in 4 patients) and an average follow-up period of 5.8 years (standard deviation, 1.6 years) were included for analysis. Active forward elevation (77° vs. 124°, P<.00001) and abduction (60° vs. 90°, P<.00001) both improved significantly after fusion. Average internal rotation after fusion was at spinal level L3-L4. The visual analog scale pain score (2.6 vs. 1.2, P<.00001), Subjective Shoulder Value score (33 vs. 76, P<.00001), and American Shoulder and Elbow Surgeons (ASES) score (41.8 vs. 76.1, P<.00001) all improved significantly postoperatively. Of the shoulders, 50% (27 of 54) received treatment with cerclage wires and 50% (27 of 54) received treatment with Luque wires. Femoral head allograft was used in 53.7% of shoulders (29 of 54), whereas iliac crest autograft was used in 46.3% (25 of 54). Average radiographic time to healing was 11.1 weeks (standard deviation, 3.2 weeks), with no incidence of nonunion, and did not significantly differ by bone graft type (P=.26) or technique (P=.20). The complication rate was 24.1%, including seroma (n=3), superficial infection (n=2), transient neurologic injury (n=2), hemothorax (n=1), rib fracture (n=1), pneumothorax (n=1), and shortness of breath (n=1), although none requiring reoperation. There was no significant difference in the rate of postoperative complications when compared by surgical technique (P=.81) and bone graft type (P=.93). There were no independently predictive factors influencing the rate of postoperative complications by multivariate regression. Regression analysis showed that the postoperative ASES score was independently associated with the preoperative ASES score (P<.0001), use of iliac crest autograft (P<.011), and presence of complications (P<.043). Patients receiving ST fusion for FSHD demonstrate globally improved active motion and patient-reported outcome measures. Fusion construct or type of bone graft does not affect time to union or complication rates. Surgeons should be aware of a relatively high complication rate in the early postoperative period.