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The Journal of Bone and Joint Surgery (American) 83:S98-103 (2001)
© 2001 The Journal of Bone and Joint Surgery, Inc.

Scientific Article

Bone-Graft Substitutes: Facts, Fictions, and Applications

A. Seth Greenwald, DPhil(Oxon), Scott D. Boden, MD, Victor M. Goldberg, MD, Yusuf Khan, MS, Cato T. Laurencin, MDPhD and Randy N. Rosier, MD for the Committee on Biological Implants

A. Seth Greenwald, DPhil(Oxon)
Orthopaedic Research Laboratories, Lutheran Hospital, Cleveland Clinic Health System, 1730 West 25th Street, Cleveland, OH 44113. E-mail address: seth@orl-inc.com

Scott D. Boden, MD
Emory Spine Center, 2165 North Decatur Road, Decatur, GA 30033

Victor M. Goldberg, MD
Case Western Reserve University School of Medicine, 11100 Euclid Avenue, Cleveland, OH 44106

Yusuf Khan, MS
Cato T. Laurencin, MD, PhD
Center for Advanced Biomaterials and Tissue Engineering, 3141 Chestnut Street, Philadelphia PA 19104
Randy N. Rosier, MD
University of Rochester, 601 Elmwood Avenue, Box 665, Rochester, NY 14642

Acknowledgments: GenSci OrthoBiologics, Incorporated; Interpore Cross International; Osteotech, Incorporated; Wright Medical Technology, Incorporated; and Zimmer, Incorporated.

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

The first 150 words of the full text of this article appear below.


   The Emergence of Bone-Grafting
 
It is estimated that more than 500,000 bone-grafting procedures are performed annually in the United States, with approximately half of these procedures related to spine fusion. These numbers easily double on a global basis and indicate a shortage in the availability of musculoskeletal donor tissue traditionally used in these reconstructions (Fig. 1).


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  		Fig. 1: United States trends in musculoskeletal tissue donors. Source: United Network for Organ Sharing and the Musculoskeletal Transplant Foundation.

 
This reality has stimulated a proliferation of corporate interest in supplying what is seen as a growing market in bone-substitute materials (Fig. 2). These graft alternatives are subjected to varying degrees of regulatory scrutiny, and thus their true safety and effectiveness in patients may not be known prior to their use by orthopaedic surgeons. It is thus important to gain insight into this emerging class of bone-substitute alternatives.


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  		Fig. 2: United States sales of bone graft and bone . . . [Full Text of this Article]

 

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