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Abstract
Background: Autologous bone grafts have long been considered the gold standard for the treatment of bone defects, however the disadvantages include small quantity, increased surgical time, blood loss, and damage to the donor sites. Therefore, allografts are an effective option in terms of both safety and treatment costs. This article aims to develop a preservation process of fresh frozen allograft bone and evaluate its effectiveness in the treatment of some orthopedic trauma diseases.
Methods: Preservation process of fresh frozen allograft bone: 100 patients with femoral neck fractures were selected for femoral head donation based on the criteria of the American Association of Tissue Banks and serological, molecular, pathological and culture tests in screening for infectious diseases. Evaluation of the effectiveness of bone graft: a prospective study was conducted on 30 patients with bone defects requiring grafting at the Orthopedics and Plastic Center, Hue Central Hospital from August 2022 to October 2024. Surgical results were evaluated based on imaging, clinical criteria and quality of life at last follow-up, at least 6 months.
Results: The mean age was 47.5 ± 20,0 (from 11 to 73 years old). Of which, men accounted for 2/3 of the total number of patients. The mean follow-up time was 8,5 ± 2,5 months (6-13 months). The average allograft weight was 40,4 ± 15,6 gram, with the minimum and maximum figures were 20 g and 82 g, respectively. The follow-up results showed 60.0% had good, 36,7% had fair and 3,3% had bad results. Postoperative period recorded 1 case of prolonged wound discharge and 1 case of prosthetic hip dislocation. At 2 months follow-up, there was 1 case of periprosthetic fracture after knee arthroplasty surgery and 1 case of prosthetic joint infection after revision hip arthroplasty surgery. For the assessment of Quality of Life according to the EQ - 5D - 5L questionnaire for Vietnamese people, the average preoperative and 6 months postoperative figures were 0.4375 ± 0.2100 and 0.8444 ± 0.1479 respectively, showing a good improvement in health status.
Conclusions: Fresh frozen bone allograft is a potential alternative that can be routinely stored and used in orthopaedic surgery. Long-term results are promising and may pave the way for wider use, however more studies with larger numbers of patients and follow-up periods are needed to verify this.
References
Migliorini F, La Padula G, Torsiello E, Spiezia F, Oliva F, Maffulli N. Strategies for large bone defect reconstruction after trauma, infections or tumour excision: a comprehensive review of the literature. Eur J Med Res. 2021;26(1):118.
Schmidt AH. Autologous bone graft: Is it still the gold standard? Injury. 2021;52 Suppl 2:S18-S22.
Baldwin P, Li DJ, Auston DA, Mir HS, Yoon RS, Koval KJ. Autograft, Allograft, and Bone Graft Substitutes: Clinical Evidence and Indications for Use in the Setting of Orthopaedic Trauma Surgery. J Orthop Trauma. 2019;33(4):203-213.
Wiese A, Pape HC. Bone defects caused by high-energy injuries, bone loss, infected nonunions, and nonunions. Orthop Clin North Am. 2010;41(1):1-4, table of contents.
Wang W, Yeung KWK. Bone grafts and biomaterials substitutes for bone defect repair: A review. Bioact Mater. 2017;2(4):224-247.
Ocksrider J, Boden AL, Greif DN, Hernandez R, Jose J, Pretell-Mazzini J, et al. Radiographic evaluation of reconstructive surgery for segmental bone defects: What the radiologist should know about distraction osteogenesis and bone grafting. Clin Imaging. 2020;67:15-29.
Beaman FD, Bancroft LW, Peterson JJ, Kransdorf MJ, Menke DM, DeOrio JK. Imaging characteristics of bone graft materials. Radiographics. 2006;26(2):373-88.
Anjali MM, D.; Vandana, K.D. Overview of Imaging Modalities in Evaluation of Bone Allograft Viability. Journal of Radiation and Nuclear Medicine. 2021;1:1-5.
Board TN, Brunskill S, Doree C, Hyde C, Kay PR, Meek RD, et al. Processed versus fresh frozen bone for impaction bone grafting in revision hip arthroplasty. Cochrane Database Syst Rev. 2009;2009(4):CD006351.
Ngô Minh Tứ, Ghép xương đồng loại, thực nghiệm và ứng dụng lâm sàng, in Luận án tiến sĩ y học. 2003, Đại học Y Hà Nội.
American AoTB, Guidance Document Tissue Donor Physical Assessment Form.
Raghu YJ, P.; Sadhan, P. The outcome of fresh frozen allografts in bone healing: a prospective study, in a tertiary care centre, India. International Journal of Research in Orthopaedics. 2022;8:272-232.
Mai VQ, Sun S, Minh HV, Luo N, Giang KB, Lindholm L, et al. An EQ-5D-5L Value Set for Vietnam. Qual Life Res. 2020;29(7):1923-1933.
Cadena-Ullauri SG, A.; Guevara-Ramirez, P.;Zambrano, K. Nucleic acid amplification testing (NAT) impact on blood safety compared to Immunoassays in blood banks: A Review. Latin American Journal of Biotechnology and Life Sciences. 2023.
Strahl A, Boese CK, Ries C, Hubert J, Beil FT, Rolvien T. Outcome of different reconstruction options using allografts in revision total hip arthroplasty for severe acetabular bone loss: a systematic review and meta-analysis. Arch Orthop Trauma Surg. 2023;143(10):6403-6422.
Deren ME, Pannu TS, Villa JM, Firtha M, Riesgo AM, Higuera CA. Meta-analysis Comparing Allograft to Synthetic Reconstruction for Extensor Mechanism Disruption after Total Knee Arthroplasty. J Knee Surg. 2021;34(3):338-350.
Gilbody J, Taylor C, Bartlett GE, Whitehouse SL, Hubble MJ, Timperley AJ, et al. Clinical and radiographic outcomes of acetabular impaction grafting without cage reinforcement for revision hip replacement: a minimum ten-year follow-up study. Bone Joint J. 2014;96- B(2):188-94.
Ibrahim MS, Raja S, Haddad FS. Acetabular impaction bone grafting in total hip replacement. Bone Joint J. 2013;95-B(11 Suppl A):98-102.
Beckmann NA, Mueller S, Gondan M, Jaeger S, Reiner T, Bitsch RG. Treatment of severe bone defects during revision total knee arthroplasty with structural allografts and porous metal cones-a systematic review. J Arthroplasty. 2015;30(2):249-53.
Byttebier P, Dhont T, Pintelon S, Rajgopal A, Burssens A, Victor J. Comparison of Different Strategies in Revision Arthroplasty of the Knee with Severe Bone Loss: A Systematic Review and Meta-Analysis of Clinical Outcomes. J Arthroplasty. 2022;37(6S):S371-S381 e4.
Trần Trung Dũng NTQS. Phẫu thuật thay khớp gối toàn bộ kèm đoạn xương ghép đồng loại điều trị tổn thương u xương vùng lồi cầu đầu xương đùi: nhân 5 trường hợp. Tạp ch Y học Việt Nam 2020:188-190.
| Published | 21-11-2024 | |
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| Issue | Vol. 16 No. 7 (2024) | |
| Section | Original article | |
| DOI | 10.38103/jcmhch.16.7.14 | |
| Keywords | Xương ghép đồng loại, xương tươi đồng loại bảo quản lạnh sâu Bone allograft, fresh frozen bone allograft |
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