Vascularized fibular flaps enhance histological repair in pasteurized autogenous bone graft

The healing process of structural pasteurized autogenous bone graft has not been studied in detail. The purpose of this investigation was to assess the reparative process of pasteurized bone graft histologically, and clarify the factors influencing the outcome. From among 51 cases using pasteurized autogenous bone graft since 1992, 10 specimens were retrieved after lower extremity reconstruction of tibia or femur with or without simultaneous fibula flap, and subjected to the analysis. Regeneration of the grafted bone was assessed as the ratio of the number of viable cells to that of whole cells. Pasteurized bone combined with a vascularized fibula showed markedly better repair. Long duration from implantation to retrieval was associated with a better reparative process with vascularized fibula (P = 0.03), whereas other factors had no significant impact. This study demonstrated that pasteurized autogenous bone graft remained structurally stable for many years, although facilitators such as the combined use of a vascularized fibula are required to promote regeneration of the graft.