Albumin-coated structural lyophilized bone allografts: a clinical report of 10 cases |
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Authors: | Tamás Klára Lajos Csönge Gábor Janositz Zoltán Csernátony Zsombor Lacza |
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Affiliation: | 1. Trauma Department, Erzsébet Teaching Hospital, Gy?ri út 15, Sopron, 9400, Hungary 2. Aladár Petz County Teaching Hospital, Western Hungarian Regional Tissue Bank Gy?r, Vasvári Pál street 2-4, Gy?r, 9023, Hungary 3. Orthopedic Department, County Hospital Kecskemét, Nyíri street 38, Kecskemét, 6000, Hungary 4. Department of Orthopedic Surgery, University of Debrecen, Medical and Health Science Center, Nagyerdei street 98, Debrecen, 4032, Hungary 5. Department of Orthopedics, Semmelweis University, Karolina út 27, Budapest, 1113, Hungary 6. Department of Human Physiology and Clinical Experimental Research, Semmelweis University, T?zoltó u. 37-47, Budapest, 1094, Hungary
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Abstract: | Bone replacement and the use of bone supplementary biological substances have become widespread in clinical practice. Although autografts have excellent properties, their limited availability, difficulties with shaping and donor site morbidity have made allografts a viable and increasingly preferred alternative. The main drawback of allografts is that the preparation destroys osteogenic cells and results in denaturation of osteoinductive proteins. Serum albumin is a well-known constituent of stem cell culture media and we found that lyophilizing albumin onto bone allografts markedly improves stem-cell attachment and bone healing in animal models thus replacing some of the osteoinductive potential. As a first step in the clinical introduction of albumin coated grafts, we aimed to test surgical handling and early incorporation in aseptic revision arthroplasty in humans. We selected patients who needed large structural allografts and the current operation was the last attempt at preserving a moving joint. In a series of 10 cases of hip and knee revision surgery we did not experience any drawbacks of the albumin-coated grafts during handling and implantation. Twelve months radiographic and SPECT-CT follow-up showed that the graft was well received by the host and active remodelling was observed. The lack of graft-related complications and the good 1-year results indicate that controlled trials may be initiated in more common bone grafting indications where long-term effectiveness can be evaluated. |
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