Mechanically and ultrasonically processed lyophilized allogeneic bone biografts for filling post-resection bone cavities in children with benign bone lesions

BACKGROUND: In almost all cases, removal of benign intraosseous tumors requires reconstruction of the post-resection bone defect. Autologous bone grafts are considered the ideal graft material. However, their use is limited by the amount and volume of available tissue. Allogeneic grafts, in contrast, not only possess sufficient structural characteristics and quantity but can also be combined to match the specific dimensions and site of the lesion.
CLINICAL CASE DESCRIPTIONS: This paper presents clinical cases derived from a study conducted at the Department of Pediatric Bone Pathology and Adolescent Orthopedics of the Priorov National Medical Research Center of Traumatology and Orthopedics. The study analyzed treatment outcomes in 309 children aged from 1 year 10 months to 17 years inclusive with benign bone lesions. Analysis of medical records showed that allografts were used both as standalone materials and in combination with each other and with autografts. Cortical bone strips and cancellous bone chips were the most frequently used graft types, either alone or in combination. A recurrence-free postoperative course with organotypic remodeling of the allografts was observed in 93.85% of patients. Pediatric patients diagnosed with bone cysts underwent surgery using mechanically and ultrasonically processed lyophilized allogeneic biografts to fill the post-resection cavity after removal of the pathological focus. When the lesion was located in a long bone (humerus), cortical bone strips were used; when localized in cancellous bone (calcaneus), cancellous powder was applied. In both cases, at a 2-year follow-up, no recurrence was detected, and organotypic remodeling of the grafts was observed.
CONCLUSION: The obtained results demonstrate the feasibility and necessity of using mechanically and ultrasonically processed lyophilized allogeneic bone biografts for filling post-resection bone cavities after removal of benign bone tumors. These biografts can be used both individually and in various combinations without compromising surgical outcomes. The minimal risk of recurrence and infection, along with complete organotypic remodeling of the grafts, makes them the material of choice in pediatric and young patients, as such surgical intervention does not adversely affect subsequent procedures that may be required at the same anatomical site.