2002, Number 4
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Acta Ortop Mex 2002; 16 (4)
Alternate procedures for harvesting bone grafts
Rojas DS, Domínguez HVM
Language: Spanish
References: 75
Page: 225-231
PDF size: 57.26 Kb.
ABSTRACT
One of the biggest problems in orthopedics is the reconstruction of bony defects after infections, trauma or block resection of bone tumors, since bone allografts availability is limited. For that reason, alternatives to obtain a viable bone graft are studied: 1) cultured in vitro bone cells (osteoblasts) as their osteoinduction and biocompatibility characteristics, make them an attractive option, 2) human recombinant bone morphoprotein-2 (rhMBP-2), that is useful for reconstruction big segments, 3) growth factors (IGF I y II, TGF-b, FGFa,b, PDGF and BMP) have a potential to increase bone mass, however their role in bone remodeling and their capacity to increase bone mineral density are still unknown. Additionally, they can form neoplasms, if they are not managed appropriately, 4) the frozen and demineralized bone reduces the immune response and favor osteoinduction, 5) autologous cancellous bone, is considered the ideal graft, since it provides osteoprogenitor cells (osteoblasts) with appropriate biomechanical strength. However, their availability is limited and, 6) cytokines produced by osteoblasts (IL-1, IL-6) that participate in the bony formation and resorption; as well as cytokines produced by osteoclasts (TNF-a, IL-1b, INF-g and annexin II) that maintain hematopoiesis and normal immune function. Biomechanical properties of bone grafts are analyzed, as well as the experimental animal models that are used to evaluate them.
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