The American Association of Tissue Banks tissue donor screening for Mycobacterium tuberculosis-Recommended criteria and literature review.

After two multistate outbreaks of allograft tissue-transmitted tuberculosis (TB) due to viable bone, evidence-based donor screening criteria were developed to decrease the risk of transmission to recipients. Exclusionary criteria, commentary, and references supporting the criteria are provided, based on literature search and expert opinion. Both exposure and reactivation risk factors were considered, either for absolute exclusion or for exclusion in combination with multiple risk factors.

Cryopreserved, Thin, Laser-Etched Osteochondral Allograft maintains the functional components of articular cartilage after 2 years of storage.

Background: Despite improvements in treatment options and techniques, articular cartilage repair continues to be a challenge for orthopedic surgeons. This study provides data to support that the 2-year Cryopreserved, Thin, Laser-Etched Osteochondral Allograft (T-LE Allograft) embodies the necessary viable cells, protein signaling, and extracellular matrix (ECM) scaffold found in fresh cartilage in order to facilitate a positive clinical outcome for cartilage defect replacement and repair.

Methods: Viability testing was performed by digestion of the graft, and cells were counted using a trypan blue assay.

Cross talk from pets to people: translational osteosarcoma treatments.

Osteosarcoma is almost identical in companion animals and in people, so research in basic cancer biology and treatment is readily translational across the species. In this article the authors (one DVM and one MD) present examples of species "cross talk" based on their parallel careers in musculoskeletal oncology surgery. Dogs in particular provide a relevant osteosarcoma model that is 10 times more prevalent than the corresponding human condition and offers a unique opportunity to answer questions related to local tumor control and metastasis.

Osteochondral lesions of the talus treated with fresh talar allografts.

Background: Osteochondral lesions of the talar dome (OLT) can be devastating injuries. Many of these problems occur in younger adult patients and can cause permanent joint pain and stiffness. Several treatment methods have been used to treat the symptomatic lesion, including arthroscopic debridement and microfracture, transfer of autologous osteoarticular tissue from the knee or talus (OATS), autologous chondrocyte implantation (ACI), frozen and fresh allograft transplantation.

Case report: Osteochondritis dissecans in twins: treatment with fresh osteochondral grafts.

Osteochondritis dissecans is a lesion of subchondral bone with subsequent involvement of the overlying cartilage. Although the etiology of the disease is unknown, mechanical, traumatic, and ischemic etiologies have been suggested, in addition to developmental and genetic factors. There are several treatment options depending on the stage of the disease and surgeon preference.

Bread mold osteomyelitis in the femur.

Rhizopus osteomyelitis is an uncommon and often fatal infection that usually occurs in immunocompromised patients. The infection is commonly referred to as "bread mold." The usual course of treatment is Amphotericin B, debridement, and, if needed, amputation of the affected limb.

Intraarterial chemotherapy for extremity osteosarcoma and MFH in adults.

Unlabelled: The neoadjuvant treatment of osteosarcoma using intravenous agents has resulted in survival rates of 55% to 77% [3, 5, 6, 20, 22, 35]. We designed a neoadjuvant chemotherapy protocol using combined intraarterial and intravenous agents to treat high-grade osteosarcoma and malignant fibrous histiocytoma of bone in an attempt to improve survival. We report the results of treating 53 adults (age 18-77 years) diagnosed with nonmetastatic extremity osteosarcoma or malignant fibrous histiocytoma.

Reconstruction options for pediatric bone tumors about the knee.

The surgical decisions involved with high-grade sarcoma surgery about the knee in pediatric patients are complicated. The orthopedic oncologist must have experience as well as a great deal of insight into the intricacies of each procedure and the wishes and demands of patients--not only while they are young but in into their adult life. It is difficult to predict the interests and vocation young patients will choose as their lives progress.

The value of serial arteriography in osteosarcoma: delivery of chemotherapy, determination of therapy duration, and prediction of necrosis.

Purpose: To investigate the value of serial arteriography to assess tumor response, predict necrosis, and individualize the duration of a combined intravenous (IV) and intraarterial (IA) neoadjuvant chemotherapy protocol in patients with biopsy-proven high-grade osteosarcoma or malignant fibrohistiocytoma of bone.

Materials And Methods: Between July 1987 and March 2003, 109 patients completed a chemotherapy protocol of neoadjuvant IV doxorubicin and IA cisplatin. Patients were eligible regardless of age, disease stage, or disease site.

Treatment of benign bone lesions with an injectable calcium sulfate-based bone graft substitute.

The treatment of benign bone lesions can be challenging due to the limited quantity of autogenous graft available for harvest and grafting of the defect. The use of an injectable calcium bone graft substitute, Minimally-Invasive Injectable Graft (MIIG) (Wright Medical Technology, Inc, Arlington, Tenn), material for treatment of these bone lesions is advantageous. Calcium sulfate has a long-standing history in the treatment of bone voids secondary to trauma, infection, or neoplastic processes.

Early multicenter experience with a noninvasive expandable prosthesis.

A noninvasive expandable prosthesis for skeletally immature children after limb salvage surgery has been developed. Between 1998 and 2001, 18 Phenix prostheses were implanted in 15 pediatric patients who had been diagnosed and treated for osteosarcoma about the knee. Of the 15 original prostheses, 10 were implanted at the time of primary tumor resection and five were revisions from an endoprosthetic modular knee system.

Treatment of metastatic disease of the tibia.

Metastatic lesions to bone outnumber primary bone malignancies. Osseous metastases to the tibia tend to be less common than osseous metastases to other long bones. This study examined the treatment options for a population of patients with metastatic disease to the tibia, with surgical intervention being the cornerstone of treatment for the osseous lesion.

Reoperation after limb preservation surgery for sarcomas of the knee in children.

Limb preservation surgery compares favorably with amputation in oncologic and functional outcomes. However, an increased incidence of complications and reoperations is associated with limb preservation. This study compared the outcome of a group of young patients who required at least one reoperation after limb preservation surgery because of a complication or need for prosthetic lengthening with the outcome of a similar group who did not require additional surgery.

Superior survival in treatment of primary nonmetastatic pediatric osteosarcoma of the extremity.

Background: A protocol to treat osteosarcoma of the extremity was developed at two local institutions.

Methods: The study involved a dose-intensified neoadjuvant protocol of intravenous doxorubicin and intra-arterial cisplatin administered repetitively until maximum angiographic response was noted. Definitive surgery was delayed until > or =90% reduction in tumor neovascularity was documented.

The effect of allomatrix injectable putty on the outcome of long bone applications.

Long bone defects due to nonunion or surgical excision of benign bone tumors result in areas that require rapid regeneration of local bone. This clinical and radiographic article details the results of a commercially prepared allograft demineralized bone matrix in patients with long bone voids or gaps. Of the 76 patients included for study, 41 (54%) patients were undergoing surgical intervention for removal of benign tumors or space-occupying lesions and 35 (46%) patients had long bone nonunions.

Percutaneous treatment of long bone nonunions: the use of autologous bone marrow and allograft bone matrix.

Sixty-six patients with 69 "stiff" nonunions (no gross motion) of long bones were entered into a prospective study. The only therapeutic intervention was the percutaneous administration of a mixture of autologous bone marrow and allograft demineralized bone matrix on an outpatient basis. Sixty-one of the percutaneous treatments (88%) resulted in union at an average of 8.

Revision of the failed distal femoral replacement to allograft prosthetic composite.

Orthopaedic oncologists often prefer a modular prosthetic cemented prosthesis for reconstruction after tumor excision in the distal femur. However, these frequently young patients face the prospect of either mechanical failure or loosening during their lifetime. Between 1993 and 2000, 41 patients (18 males, 23 females) with a malignancy of the distal femur had distal femoral replacement.