The transplantation of bone : an experimental study

Abstract

In recent years greet advances have been made in the understanding of the nature of the reaction of a host to transplants of tissue of homogenous origin. In general, such transplants fail because of the development of an immune response by the host against the transplant. The success of bone homografts in the light of this new knowledge had been largely unexplained.A. further study was, therefore, undertaken to determine whether the apparently privileged behaviour of bone homografts was due to a fundamental difference between bone and other tissues with respect to homograft immunity. The experimental work on this part of the study is described in Chapters I and II of the thesis.Chapter III of this thesis describes an attempt to evaluate different bone grafting materials in order to assess their relative clinical value. In devising a biological test for a bone graft the author has tried to eliminate some of the sources of uncertainty which had led to the conflicting conclusions of previous workers. wrong these had been the use of test situations which did not correspond to any clinical bone grafting procedure; the use of inexact methods for measuring a graft's ;progress; or the evaluation of some aspect of a graft's behaviour which was not relevant to its clinical function.Many bone graft materials have been used clinically or experimentally with apparent success as alternatives to autografts.Six of these materials which appeared to hold most promise were subjected to a comparative experimental study.Frozen, freeze-dried and freeze-died irradiated homografts were found to behave more favourably than autoclaved, demineralized and deproteinized homograft.The type of bone bank recommended for clinical use depends on the needs of the area, a frozen bone bank being satisfactory for local use, while a freeze-dried bone bank preferable where wider distribution is required.Tonizing irradiation is the most satisfactory method of sterilizing bone and may be used with either method of preservation,