Evidence brief
Bone Grafting: Biological Principles
Osteogenesis: living cells that form bone
Osteoinduction: stimulates differentiation to bone-forming cells
Osteoconduction: scaffold for bone ingrowth
Autograft: gold standard (all three properties)
Allograft: osteoconductive, weakly osteoinductive
Understanding the biology of bone grafting guides selection of graft materials and bone graft substitutes for different clinical scenarios.
Must know the three properties. Autograft sources: iliac crest (cancellous or cortico-cancellous), RIA, local bone. Allograft: structural or morcellized. Synthetics: ceramics (osteoconductive), DBM (weakly osteoinductive), BMPs (strongly osteoinductive). Know harvest site morbidity.
Khan SN et al. The biology of bone grafting. J Am Acad Orthop Surg. 2005;13(1):77-86.
Level IV
Case series or case reports