The Clinical Use of Allografts, Demineralized Bone Matrices, Synthetic Bone Graft Substitutes and Osteoinductive Growth Factors: A Survey Study

HSS Journal


Mathias P. Bostrom, MD

Attending Orthopaedic Surgeon, Hospital for Special Surgery
Professor of Orthopaedic Surgery, Weill Cornell Medical College

Daniel A. Seigerman,
Hospital for Special Surgery

Abstract
The emergence of new bone grafting options and alternatives has led to significant uncertainty when determining the most appropriate product for surgical procedures requiring bone graft in orthopedics. Allografts, demineralized bone matrices (DBMs), synthetic bone graft substitutes, and osteoinductive growth factors are all viable options, yet there is a lack of data reporting clinical usage of these products. This correspondence reports on the use of bone grafting products at the Hospital for Special Surgery over a 27-month period and makes recommendations based upon surgical usage, safety, and cost. Approximately half (48.6%) of all bone graft substitutes were implanted during spinal surgery. Arthroplasty, trauma, and foot/hand cases all used considerable amounts of bone grafting products as well, (20.1%, 19.0, 12.1% respectively). Considerable differences were noticed in usage of bone grafting products among each orthopedic discipline. 14.4% of all bone graft substitutes used in arthroplasty were DBMs while 56.8% were allografts. 82% of trauma surgery, and 89% of foot/hand cases used DBM grafts. An increase in synthetic bone graft alternatives was noticed near the end of our investigation period.

This article appears in HSS Journal: Volume 1, Number 1.
View the full article at springerlink.com.


About the HSS Journal
HSS Journal, an academic peer-reviewed journal, is published twice a year, February and September, and features articles by internal faculty and HSS alumni that present current research and clinical work in the field of musculoskeletal medicine performed at HSS, including research articles, surgical procedures, and case reports.


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