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Online ISSN 1827-1707
Friedlaender G. E.
Department of Orthopaedics and Rehabilitation Yale University School of Medicine New Haven, CT, USA
Bone allografts have proven useful in the repair and reconstruction of a wide variety of musculoskeletal disorders including traumatic bone loss, filling of benign cystic defects, reconstruction following tumor resection, and support for total joint arthroplasties. Much is known about the biology of bone graft incorporation, and the application of osteogenic and morphogenetic cytokines will improve the efficacy of these grafts even more in the future. Safety of bone allografts has also been excellent, particularly with respect to the transmission of bacterial and viral pathogens. The basis for this success reflects adherence to good tissue banking practices that stress rigorous donor testing criteria, comprehensive laboratory screening for microbial pathogens and maintenance of tissue in a sterile manner until used. Bone banks may voluntarily undergo onsite inspection and accreditation based upon these good tissue practices. Physicians and their patients are best served by the thoughtful use of bone allografts, respecting their biological and biomechanical properties and matching these characteristics to the goals of the surgical procedure. Furthermore, safety is maximized by obtaining these grafts from banks that have demonstrated their commitment to good tissue banking practices.