Use of allogenic bone graft in the treatment of benign osteolytic bone lesion

Introduction: Management of benign osteolytic lesions of bone involve intralesional excision and filling of the bone defect. Allograft used as a filler in these lesions confer advantages of being available in sufficient quantity without the risk of donor site morbidity. However use of allografts may carry a potential risk of infection and has debatable osteogenic potential. This study used Allogenic Bone Graft using antibiotic impregnated allografts and adjuvants like bone marrowso as to address these shortcomings. Materials and Methods: Eight cases of benign osteolytic lesions were treated by intralesional curettage and bone grafting using allogenic bone graft. Appropiate surgical procedure for fixation was done wherever necessary. Five cases had Allogenic Bone Graft impregnated with vancomycin solution. Three cases had autogenic bone graft while 1 case used bone marrow as adjuvant. Outcome was assessed in terms of fracture healing, infection and osteointegration. Results: In all the cases adequate osteointegration and complete healing of the lesion was observed in all the cases with time period of healing closely matching that of complete osteointegration. There was no statistically significant difference in the duration of osteointegration and bone healing between vancomycin impregnated group vis a vis allograft used alone. Only one case developed infection who responded to Intravenous antibiotics. No failure was observed in this study was probably due to use of adjuvants in half of the cases. Discussion and Conclusion: Use of allogenic bone graft alongwith adjuvants (bone marrow and autologous bone graft) appears to be effective in treatment of benign lytic lesions. Healing rates may be attributed to use of osteogenic potentiators. Vancomycin impregnation of allograft appears to be a beneficial step in controlling the graft related infection and does not affect graft osteointegration and bone healing.