A new procedure for creating and transplanting bone grafts was detailed in the August 28 issue of the medical journal The Lancet.
One drawback of bone transplantation from one part of the body to another is the creation of a secondary bone defect to treat the primary defect. German investigators treated a 56-year-old man who had had part of his jawbone removed owing to cancer. Instead of obtaining a graft from another part of the patient’s body such as his hip bone, investigators used three-dimensional computerized tomography, or CT, scanning and computer-aided design techniques to produce a replacement for the jawbone defect. Using the CT and design data, they created a titanium mesh cage that they filled with bone mineral blocks, 7 milligrams of recombinant human bone morphogenetic protein 7, and 20 milliliters of the patient’s bone marrow.
Investigators implanted the transplant into the latissimus dorsi muscle below the patient’s right shoulder blade. Seven weeks later, they transplanted the new bone graft as a free bone-muscle flap to repair the jawbone defect.
Bone remodeling and mineralization inside the transplant were evident before and after transplantation. CT provided radiologic evidence of new bone formation.
By the fourth week after transplantation, the patient was able to eat his first solid-food meal in nine years. Before reconstruction, he had been able to eat only soft foods and soup.
"The exciting nature of the result achieved in this patient to date has prompted our group to extend this trial to include additional patients," said lead author Patrick H. Warnke, M.D. "For us to draw firm conclusions, an extended period of follow-up is necessary. We hope to present this patient’s long-term outcome and those of future patients at a later date."
