Bone block allograft impregnated with bone marrow aspirate

PURPOSE: To evaluate the influence of bone marrow aspirate when added to bone block allograft to repair osseous defects. BACKGROUND: Bone-marrow aspirate has been combined with xenograft and allograft particulate material and has produced a significant quantity of new bone growth. However, the use of allograft bone blocks has advantages in some clinical situations. This article discusses cell-based therapies by means of in vivo transplantation of stem cells derived from bone-marrow aspirate and incorporated into allograft corticocancellous bone block for bone regeneration. MATERIALS: A technique for combining bone-marrow aspirate with block allografts was developed. To evaluate its influence in repairing osseous defects, a maximum of 3 to 4 mL of bone marrow was aspirated from the anterior iliac crest of 5 patients who had severely atrophic maxillary and mandibular ridges. Five sites were grafted with allograft bone blocks saturated with bone-marrow aspirate and secured with bone screws (ACE Surgical Supply Company, Inc. Brockton, MA). At one of the sites a core specimen was taken 4 months after implant placement and submitted for standard histologic and histomorphometric analysis. RESULTS: After 4 to 8 months of healing, all the grafts had integrated into the recipient bone. Implants were placed at all 5 sites and osseointegrated successfully. Examination of the bone core showed the graft to be well-integrated, with 54% of the core consisting of bone and 46% of marrow. Eighty-nine percent of the bone was vital. CONCLUSION: Impregnation of bone-marrow aspirate into allograft bone block activates the body's ability to form new bone. The bone-marrow aspiration technique is less invasive than harvesting autogenous bone from a second surgical site, offers predictable results, and is cost effective.