**5. Acknowledgment**

The authors would like to acknowledge Nathaniel Ordway at SUNY Upstate New York for help with conducting the biomechanical studies, along with Bryan Cunningham of Union Memorial Hospital for help with conducting the biomechanical and animal studies. The authors would also like to acknowledge Dr. Nadim Hallab of Bioengineering Solutions for performing the particulate analyses, along with Markus W. Wimmer and Thorsten Schwenke at RUSH Medical Center for help in conducting the wear studies.

### **6. References**


http://nrlweb.ihelse.net/eng/Report\_2010.pdf


combined preclinical studies described can be used in an ongoing basis to further analyze the use of PEEK in arthroplasty applications. Long term clinical follow up is needed to

The authors would like to acknowledge Nathaniel Ordway at SUNY Upstate New York for help with conducting the biomechanical studies, along with Bryan Cunningham of Union Memorial Hospital for help with conducting the biomechanical and animal studies. The authors would also like to acknowledge Dr. Nadim Hallab of Bioengineering Solutions for performing the particulate analyses, along with Markus W. Wimmer and Thorsten Schwenke at RUSH Medical Center for help in conducting the wear studies.

Balsano, M.; Zachos, A. & Ruggiu A. (2011). Nucelus desc arthroplasty with the NUBAC

Bergen, H. (2011). The Norwegain Arthroplasty Register, In: Centre of Excellence of Joint

Bushelow, M.; Walker, J. & Coppes J. Comparison of Wear Rates: Metal/UHWMPE and Metal-on-Metal Total Disc Arthroplasty. Trans 22nd (2007) NASS p32 Cavanaugh, D.; Nunely P. & Kerr J. (2009). Delayed Hyper-reactivity to Metal Ions After

Cunningham, B.; Hu, N. & Zorn, C. Comparative fixation methods of cervial disc

Devin, C.; Myers, T. & Kang J. (1889). Chronic failure of a lumbar total disc replacement

Francois, J.; Coessens, R. & Lauweryns P. (2007). Early removal of a Maverick disc

Fraser, R.; Ross, E. & Lowery G. (2004) AcroFlex design and results. *Spine J* Vol. 4, No. 6

Gallagher, S.; Marras, W. & Davis, K. (2005) Torso Flexion Load and the Fatigue Failure of

Garellick, G; Darrholm J & Rogmark C. (2010). The Swedish Hip Arthroplasty Register, In:

Grupp, T.; Yue, J. & Garcia R. (2008) Biotribological evaluation of artificial disc arthroplasty

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device: 2-year clinical experience. *Eur Spine J*, Vol. 20, Suppl 1 (May, 2011) pp. S36-

Cervical Disc Arthroplasty: A case report and literature review. *Spine*, Vol. 34, No.

arthroplasty versus conventional methods of anterior cervical arthrodesis: serration, teeth, keels, or screws? *J Neurosurg Spine*, Vol. 12, No. 2 (February, 2010)

with osteolysis. Report of a case with nineteen year follow up. *J Bone Joint Surg Am*

prosthesis: surgical findings and morphological changes. *Acta Orthop Belg,* Vol. 73,

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devices: influence of loading and kinematics patterns during in vitro wear simulation. *Eur Spine* J Vol. 18, No.1 (January, 2009) pp. 98-108 ISSN 0940-6719

further support the preclinical results.

40 ISSN 0940-6719

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2265-73, 2005 ISSN 0362-2436

**5. Acknowledgment** 

**6. References** 


**12** 

*Brazil* 

**The Biology of Bone Grafts** 

Carlos Roberto Galia and Luis Fernando Moreira

*Rio Grande do Sul Federal University, Porto Alegre, RS, Brazil School of Medicine, Post-Graduate Programme of Surgery and Hospital de Clinicas University Hospital Department of Surgery 1Division of Orthopaedics and 2Division of Surgical Oncology* 

The use of bone transplants in orthopaedic procedures has become crucial to treat a great number of bone diseases including bone tumour operations, knee or total hip revision arthroplasty and even beyond the orthopaedic scope such as in craniomaxillofacial surgery. Approximately 10% to 15% of the orthopaedic procedures carried out every year in the U.S.A. employ some kind of musculoskeletal transplant. Annually, about 650 thousand bone-based grafts are distributed by the American Tissue Banks, which clearly shows the

As opposed to other organs such as heart, liver or kidneys and most of the soft tissues, the bone can be processed by many ways, can be stored longer and has been implanted till recently without prior testing compatibility. Moreover, the grafts can be obtained from oneself, living or cadaver donors, or derived from other species or even from non organic biomaterials. However, the offer for grafts is far behind the demand. Despite the success rate of about 85% with the use of bone grafts in orthopaedic surgery, patient waiting list for

The homologous deep-frozen grafts have been frequently used, although availability is very limited and a certain risk of transmitting contagious diseases cannot be thoroughly ruled out. On the other hand, though homologous freeze-dried grafts have virtually eliminated the risk of transmissible diseases is still lacking availability and therefore, alternative biomaterials from synthetic or natural source have been considered and carefully studied. Among them, the use of freeze-dried grafts from bovine sources is a suitable alternative with many advantages over autologous or homologous deep-frozen ones due to their great physicochemical and structural resemblance to human bone and their practically endless availability. As a non specific xenograft however, it may possibly present adverse immunological and inflammatory reactions. Nevertheless, our physicochemical processing protocols have been developed in order to significantly minimise these problems, decreasing antigenicity and thus, turning the bovine freeze-dried bone an important

Up to date, it is necessary, an increased knowledge about some kinds of available grafts including biological and mechanical aspects, sources and a careful analysis of outcomes, since transplant of grafts in general is responsible for a remarkable improvement in people's quality of life and their social reinsertion. Moreover, bone implants are far from being a

importance of processing, controlling and storage of this type of material.

biomaterial for large use in reconstructive surgery.

these grafts keep growing day by day either in the public or private health service.

**1. Introduction** 

