Bone Allografts: Products and Clinical Applications in Iran

Abstract

Bone allografts have become an accepted technology to replace bone loss due to common diseases, such as tumor resection, trauma, and failed total joint arthroplasty. This study briefly reviews a branch of regenerative medicine related to bone allografts and its related aspects. As new allografts stimulate an immune rejection response, bone grafts are usually prepared by freezing or freeze-drying to decrease the immune system responses. The notable biological events of associations, such as hemorrhage and inflammation, osteogenesis, osteoinduction, osteoconduction, and impressive remodeling, result in a load-bearing structure. Generally, cancellous allografts are effectively incorporated, while cortical grafts remain an admixture of viable regenerated bone and old necrotic bone for a prolonged duration. Massive bone allografts used in reconstructing tumor resection have a long-term successful outcome in about 80 percent of the procedures. Similar success has been reported for its use in total joint revision surgery and other clinical applications. The significant complications reported for grafting procedures are infection, bone graft fracture, nonunion at the graft-host juncture, and rare massive allograft resorption. Although bone allografting is a successful therapeutic approach, emerging technologies will introduce more efficient bones by mobilizing the adjunctive growth factors, cell and gene-based therapies, and tissue engineering techniques. The primary and applicable knowledge of bone allografts is essential; however, continual investigations are necessary.