Autologous bone graft in the treatment of post-traumatic bone defects: a systematic review and meta-analysis

BMC Musculoskeletal Disorders

Research Article

Irene Santi¹  Alexander Joeris¹  Mauricio Kfuri²  Alessandro Aprato³  Alessandro Masse³  Matheus Lemos Azi⁴ 

[1] AO Clinical Investigation and Documentation, Stettbachstrasse 6, 8600, Dübendorf, Switzerland;Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus - Ribeirão Preto Medical School, University of São Paulo (FMRP-USP), Av. Bandeirantes 3900, 14048-900, Ribeirão Preto, São Paulo, Brazil;Department of Orthopaedic Surgery, University of Missouri, 1100 Virginia Avenue, Columbia, Missouri, USA;Department of Orthopaedic Surgery, San Luigi Hospital of Orbassano, University of Turin, Regione Gonzole n.10, 10043, Turin, Italy;Manoel Victorino Hospital, Conselheiro Almeida Couto square S/N, 40050-410, Salvador, Bahia, Brazil;

关键词: Bone graft;    Segmental bone defect;    Large bone defects;    Bone reconstruction;   

DOI  :  10.1186/s12891-016-1312-4

 received in 2016-05-06, accepted in 2016-10-26,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThis meta-analysis aimed to determine the bone union rate of bone defects treated with the different autologous bone graft techniques.MethodsThe PubMed and the Cochrane Library databases were searched using the terms: ‘fracture’ AND (‘bone loss’ OR ‘defect’ OR ‘defects’) AND ‘bone graft’, restricted to English language, to human species, and to a publication period from January 1999 to November 2014. Data were extracted by one of the reviewers and then checked by the second. A quality of evidence score and a methodology score were used. Heterogeneity was assessed. A random effects model approach was used to combine estimates.ResultsOut of 376 selected studies only 34 met the inclusion criteria. The summary pooled union rate was 91 % (95 % CI: 87–95 %) while union rate after additional procedures raised to 98 % (95 % CI 96–99 %). No association between union rate and bone defect size was found. (Univariable regression model: vascularized: P = 0.677; non-vascularized: 0.202. Multivariable regression model: vascularized: P = 0.381; non-vascularized: P = 0.226). Vascularized graft was associated with a lower risk of infection after surgery when compared to non-vascularized graft (95 % CI 0.03 to 0.23, p < 0.001).ConclusionThe results of this meta-analysis demonstrate the effectiveness of autologous graft for bone defects. Furthermore, from the available clinical evidence bone defect size does not seem to have an impact on bone union when treated with autologous bone graft techniques.

【 授权许可】

CC BY   
© The Author(s). 2016