Abstract: Aim of study was to use the allogenic bone graft with or without vancimpregnation in osteoreconstrutive surgery and compare the results with respect to:
• Efficacy and safety in prevention of graft related and surgical site infection.
• Effect on bone healing and osteointegration.
Materials & Methods: In our study a total of 30 patients who required allogenic bone grafting for varied indications and gave informed consent for participation in the study were included. Patients with active osteoarticular infection at the proposed surgical site and with any medical contraindication to the use of vancomycin were excluded from the study. Broadly three indications for which allogenic bone graft was used included fractures, benign osteolytic lesions and miscellaneous indications which included allograft use for lumbar spinal fusion and for augmenting acetabular reconstruction.
Observation & Result
Infection: An overall infection rate of 3.3% (1 out of 30 cases) was found in this study which is much lower than what is mentioned in the literature as infection rates ranging from 4-12% have been reported by different workers
Osteointegration: The overall success rate in terms of adequate osteointegration in our study was 83.33% (5 failure cases out of 30) with 12 cases (80%) out of 15 in study group and 13 cases (86.7%) out of 15 achieving adequate osteointegration and there was no significant difference (p value=1) between the two groups.
Bone Healing: Fractures: In cases of fractures a good overall union rate of 88.8% was obtained with 16 out of 18 patients achieving adequate union. The two failure cases brought down the union rate to about 77.7% in the study group as compared to 100% union rate in the control group but this difference was not statistically significant with p value of 0.384 Thus vancomycin impregnation was not found to affect fracture union in our study.
Benign bone lesion: A total of eight patients (3 each of SBC and GCT and 2 of ABC) were included. After random allocation five patients (2 each of SBC and GCT and 1 of ABC) came under the study group and three patients (1 patient each of SBC, GCT and ABC) under control group. The mean age of patients in the study group and control groups was 25.2 years and 34.1 years respectively and thus were comparable. There was no significant difference in terms of lesion healing between the two groups (p value= 0.684) as all the eight patients (100%) showed adequate healing as defined by Neer’s classification [1].
