Biologics vs. other materials
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Allograft vs. other options:
When you recommend surgery for your patients, in most cases you have options. Will you use allograft, autograft or metal/synthetic implants?
Autograft:
While autograft is osteoconductive (provides a scaffold for new bone to attach to) and osteoinductive (stimulates growth of new bone), it must be harvested from the patient’s body in a painful and potentially dangerous second surgery. In some cases, the patient may not even have sufficient quantities of tissue suitable for transplant; when they do and autograft is harvested, complications may occur such as morbidity at the harvest site, infection, nerve and artery damage, joint instability acute or recurrent pain. In addition, this second surgery means additional time under anesthesia.
Metals/synthetics:
Metals can be tooled for specific applications and are designed for use with instrument sets for faster and more precise surgeries. The patient spends less time on the operating table, and the surgeon has a uniform process that can be repeated easily. However, metals and synthetics do not promote bone remodeling and since the material is stiffer than the adjoining bone, can actually cause weakening and fragility of surrounding bone or even cause it to disappear in these areas. In many cases, there is no metal or synthetic option, such as for tendons or other soft tissue used in sports medicine repair.
Allograft:
When properly processed, the patient’s body remodels with allograft the same way it does with autograft. There is no rejection of allograft, and no “typing” required. Allograft has all the advantages of autograft, such as remodeling, without the complications and danger of a second surgery site. Additionally, unlike autograft, which must be shaped in the operating room, allograft can be pre-shaped and precision tooled like metals, decreasing the amount of time required in surgery.
Great strides have been made in allograft safety with the invention of technologies such as RTI Biologics BioCleanse® Tissue Sterilization Process; with BioCleanse®, the risk of disease transmission through allograft transmission is essentially eliminated.