An overview of the histology of skeletal substitute materials.

Overview

CONTEXT: Orthopedic and spine surgeons are in frequent need of bone for skeletal reconstruction. The amount of autograft is limited, and conventional allograft has some disadvantages, so surgeons are now using increasing amounts of demineralized allograft and a variety of synthetic materials to replace or "extend" autograft. OBJECTIVE: To provide an overview of the composition and histology of the materials most likely to be seen by pathologists today. DATA SOURCES: The review is based on published literature and the author's experience with preclinical studies and human biopsies. CONCLUSIONS: Pathologists are likely to find these skeletal substitute materials in biopsy and resection specimens from patients who have undergone prior treatment, and recognizing a synthetic bone substitute can help explain an otherwise confusing specimen. Pathologists also play an important role in helping define the safety and efficacy of new bioactive materials.