The efficacy of application of lyophilized, radiation-sterilized bone graft in orthopedic surgery.

The purpose of this study is retrospective analysis of clinical application of lyophilized (freeze-dried), radiation-sterilized allografts in various orthopedic disorders. Grafts of this type have been produced by Polish tissue banks for many years, even before the production of deep-frozen grafts was started. This type of graft is still produced because of their easy storage, transportation, and distribution. Their application is successful in selected cases. Freeze-dried, radiation-sterilized cancellous or cortical-cancellous blocks, cancellous chips, or diaphyseal cortical struts were applied in 435 patients ranging from three to 74 years old. There were five main groups of procedures: posterior or anterior spine fusion, 224 cases; joint arthrodeses, 36 cases; reconstructive operations, 83 cases; filling of bone lesions, 59 cases; and posttraumatic reconstructive operations, 33 cases. The efficacy of application of lyophilized, radiation-sterilized allografts was estimated retrospectively on the basis of physical examination data and roentgenographic assessment collected during postoperative visits. Incorporation and rebuilding of the grafts as well as a satisfactory therapeutic effect were achieved in 394 (91%) patients. Excluding the cases of congenital and hypovascular pseudoarthroses, post-osteomyelitis gap and focuses, as well as Stage 2 bone lesions, it is suggested that lyophilized, radiation-sterilized allografts can be applied on the condition that intimate contact between the donor bone and host bed is complete and sustained.