[15 years allogeneic bone transplantation. Indications, treatment and results]

Experience with more than 2000 allogeneic bone transplantations between 1975 and 1990 confirms that implantation of allogeneic, frozen preserved bone material has a wide range of applications. Use in reconstructive surgery and after tumor resection, in particular, is increasing. The main advantage of allogeneic bone transplantation is the almost unlimited availability and the possibility of en bloc and orthotopic administration. The primary application of allogeneic transplants for the treatment of multiply traumatized patients avoids the additional operative stress required for autogeneic harvesting. The composite graft is a special application with the advantages of both the high osteogenic potency of the autogeneic, and the unlimited availability of the allogeneic, bone material. Composite grafts have been used especially frequently for the treatment of pseudarthrosis and after tumor resection. Even with extensive defects we saw satisfying results. In the case of defects greater than 10 cm in length, however, pseudarthrosis developed in nearly 50%. An overall 4.5% complication rate after allogeneic bone transplantation is negligible, compared with other published results and with due consideration for the severity of the cases presented. Bone infection is the complication most frequently seen. In fracture treatment the complications result from the high rate of complex fractures (type C of the AO classification) and the nearly 20% accounted for by open fractures in our patient population. Transplantation is still a great challenge in pseudarthrosis and after tumor resection. The healing tendency after allogeneic bone transplantation is satisfactory; although more prolonged than with autogeneic material, consolidation is nearly the same after 30 weeks. Full weight-bearing is reached depending on the defect length at approximately 14 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)