[Allogeneic transplants for biological reconstruction of bone defects]

A combination of allogeneic and autologous bone transplants is frequently used for the biological reconstruction of bone defects. Autologous bone transplants can be used either in the form of structural or cancellous bone transplants. The osteogenic potential of autologous cancellous bone is well-known and is still the gold standard with respect to osteoinduction and remodelling. Structural transplants, such as fibular and tricortical iliac crest grafts can be transplanted either free, i.e. non-vascularized or vascularized with anastomosed vessels. Allogeneic bone transplants can be used in a spongiose or structural form. In revision endoprosthetics the use of allogeneic bone transplants has essentially been reduced to impaction grafting, due to the introduction of trabecular metal as a permanently stable substitute. Allogeneic transplants have been restricted due to 3D-printing and the associated individually adapted reconstruction. In individual cases combined reconstruction consisting of allograft and endoprosthesis provide the advantage of safe load transmission and permanent reconstruction by the endoprosthesis and the possibility of soft tissue insertion of the allograft.