Tuli

By Surendar Tuli

One has to resort to allogenic source of bone grafts especially in filling up of large or multiple containable cavitary lesions, structural reconstruction of large circumferential osteoperiosteal defects, extensive spinal fusions for gross deformities, or extensive operative reconstruction after total joint replacements. These procedures demand an abundant quantity of bone material in which a patient’s (recipient’s) body cannot supply without significant morbidity and risks. At present most of the allogenic bone banks use deep-freezing or freeze-drying or radiation for long-term preservation. The techniques maintain sterility, reduce immunogenicity, and provide adequate structural integrity; however, such procedures reduce the bone-forming biological activity and are expensive. We have worked for clinical translation of the basic research performed by Marshal Urist (1965–1994). After extensive experimental observations, we have been using partially decalcified allogenic bone as grafts in clinical cases since 1978. Favorable outcome has been observed in benign cystic lesions, wide-gap grafting, and spinal fusions. Minimum follow-up for declaring “success” or “failure” of the procedure was 2 years after implantation.

Part of the book: Bone Grafting