Bone grafts and alternatives

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Bone grafting is the transplantation or implantation of bone or a bone substitute into a site to replace missing bone or to enhance bone healing. This chapter looks at autografts; allografts; grow factors; mesenchymal stem cells and tissue engineering; alloplastic grafts; ideal bone graft properties. Harvesting of an autogenous cancellous bone graft.

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14.1 Allografts. (a) Fine cancellous bone chips. (b) Cancellous blocks. (c) Cortical strut. (d) Cortical sections and whole bone allografts. (a, Courtesy of Veterinary Tissue Bank; bcd, Courtesy of Veterinary Transplant Services)
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14.2 (a) DBM powder, rehydrated intraoperatively and ready for application. (b) DBM putty in injectable form. (Courtesy of Veterinary Tissue Bank)
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14.3 Recombinant human BMP-2 (rhBMP-2) product. (a) Packaging, vials of active product and sterile water for reconstitution, syringes for mixing and application, and bovine collagen carrier matrix. (b) Application of reconstituted rhBMP-2 on to the collagen sponge. (c) Application of rhBMP-2-soaked collagen sponge into an fracture site. (Courtesy of Zoetis UK Ltd, UK)
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14.4 Collection of a cancellous bone autograft from the proximal humerus of a dog. (a) Use of Gelpi retractors and bone-holding forceps to expose the surgical site and immobilize the bone, prior to drilling a monocortical access hole. (b) Collection of cancellous bone autograft using a Volkmann curette. (c) Temporary storage of collected cancellous bone in a galley pot.
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