chapter  9
8 Pages

Bone substitutes

ByNorbert Passuti, Lawrence Bigotte, Sophie Touchais, Joël Delécrin, François Gouin

Bone grafting has a well recognized role in orthopaedic surgery for the treatment of nonunion, bridging diaphyseal defects and filling metaphyseal defects. However, it is associated with postoperative pain and morbidity (Summers and Eisenstein 1989, Younger and Chapman 1989). When extensive grafting is required (as in spinal arthrodesis and the management of large bony defects) adequate amounts of autologous bone may not be available. Allograft bone has been used as an alternative but it has low osteogenicity, increased immunogenicity and resorbs more rapidly than autogenous bone and the transmission of disease remains a concern.