Reconstruction of osseous defects with freeze-dried allogeneic and autogenous bone. Clinical and histologic assessment.

Freeze-dried allogeneic bone combined with autogenous particulate cancellous bone and marrow was used for reconstruction in 56 patients. With the exception of 3 patients who had infection postoperatively, the patients had complete acceptance of the composite graft system. Histologic examination at 2, 3, 12, 18, and 24 months demonstrated early incorporation, revascularization, resorption of the freeze-dried component, and formation of a bone ossicle that continued to remodel and form mature lamellar bone. This study suggests that freeze-dried allogeneic bone can serve as a latticework along which osteocompetent cells can proliferate, that composite grafts are readily accepted and will form a satisfactory and predictable bone ossicle over a considerable defect, and that freeze-dried allogeneic bone induces the host mesenchymal cells to differentiate into mature osteoblasts and aids in the formation of a long-lasting functional bone graft.