ABSTRACT
The standard technique to facilitate bone healing process is the
harvest and application of autogenous bone graft. Iliac crest
autograft remains today’s gold standard, since it is the only
material that contains the three essential bone formation
elements: cells, matrix, and critical growth factors. Approxi-
mately 340,000 patients undergo iliac crest graft harvesting
procedure annually; however, autogenous bone graft comes
with significant costs. Harvesting of iliac crest bone can be
associated with significant clinical morbidity which includes
donor site pain, scarring, increased surgical time, blood loss,
and risk of infection. There is also prolonged hospitalization,
delayed rehabilitation, and surgical complications, such as iliac
fracture, hematoma, nerve injury, vascular injury, lumbar
hernia, etc. (1-3). A review of the literature reveals that the
complication rate can be as high as 31%, with approximately
27% of the patients continuing to feel pain at 24 months
following surgery (4). In addition, the quantity of available
graft harvested may be less than optimal. These reasons have
led to the development and validation of alternative processes
that are capable of replicating the performance of the iliac crest
graft, while eliminating the associated complications. A variety
of materials have been utilized as substitutes for autologous
bone graft. Ceramics are one class of synthetic bone graft
substitutes which have been very useful in many clinical
orthopedic applications and have served as a useful adjunct
to minimally invasive surgery for the wrist and hand.
