[Is there still a place for bone allografts in orthopedic surgery in 2011?]

The place of bone allograft in contemporary orthopaedic surgery is discussed. Bone allograft can be prepared from retrieved femoral heads for fracture or osteoarthritis and are used as a filling material. Demineralized bone matrix is a cortical bone that has been exposed to a demineralizing solution. Doing so, the growth factors of the bone are exposed and will be able to induce the formation of new bone cells from the host. This osteoinductive capacity makes the graft more active in the process of its incorporation and has been successfully used in the conservative treatment of aneurismal bone cysts. Massive bone allografts can be used as a full segment of a long bone to reconstruct part of the skeleton either alone with fixation or with a prosthetic device. Except demineralized bone, any other types of bone allograft serve as a biologic passive support for the migrating cells from the host. Cellular therapy is another approach that allows, considering the extensive use of in vitro expanded bone, forming cells originating either from the bone marrow or the fat tissue of the patient. However, this approach needs further clinical validation before being fully considered in patient.