Not All Autologous
Bone is Equal
While autologous bone is commonly referred to as the “gold standard”, this characterization is most appropriately reserved for cancellous autologous bone that has been minimally manipulated and delivered shortly after harvesting.
Discover why cancellous autologous bone is the ideal choice for bone grafts
The Key Properties Required for Effective Grafts
Osteoinductive
Osteoinductive
Active recruitment and stimulation of stem cells, differentiate into osteoblasts and form new bone.
Osteoconductive
Osteoconductive
Passive scaffold to maintain space and allow for bone formation.
Osteogenic
Osteogenic
Osteogenic living cells, such as osteoblasts, make new bone. Osteoprogenitor cells can proliferate and differentiate to osteoblasts which turn into osteocytes.
Osteoinductive
Active recruitment and stimulation of stem cells, differentiate into osteoblasts and form new bone.
Osteoconductive
Passive scaffold to maintain space and allow for bone formation.
Osteogenic
Osteogenic living cells, such as osteoblasts, make new bone. Osteoprogenitor cells can proliferate and differentiate to osteoblasts which turn into osteocytes.
Cortical Bone (Putties)
Cortical bone, including “putties” formed from cortical remnants of high speed drilling techniques are very different from architecturally and cytologically preserved cancellous bone.
Adding Cells to Allograft
Adding cells to allograft from marrow aspirate or expanded colonies of mesenchymal stem cells, does not replicate the properties of freshly harvested and minimally manipulated autologous bone.
Suction and Auger
Use of suction (which separates marrow elements from cancellous matrix) and auger/curettage techniques (which morselize or disrupt matrix architecture) affects both osteoproliferative and osteoconductive properties of the “gold standard”.
Autologous Bone Cases and Publications
Autologous Bone Grafting in Trauma and Orthopaedic Surgery: An Evidence-Based Narrative Review
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Percutaneous Harvesting of Cancellous Bone Graft: A Surgical Technique Harvesting from the Calcaneus Using COREX
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