Expert panel review from the JBJS Committee on Biological Implants surveying the biology of bone grafting and the properties, regulatory landscape, and clinical limitations of commercially available bone-graft substitutes — asking what surgeons actually need to know before choosing one.
When selecting a bone-graft substitute, match the material's proven mechanism to the healing environment: osteoconductive substitutes are appropriate for contained metaphyseal defects but insufficient for posterolateral spine fusion, which requires osteoinductive capacity.
Treat DBM and platelet-gel products with particular skepticism — their regulatory classification as 'tissue' means clinical use can precede rigorous efficacy data.
Expert panel review from the JBJS Committee on Biological Implants surveying the biology of bone grafting and the properties, regulatory landscape, and clinical limitations of commercially available bone-graft substitutes — asking what surgeons actually need to know before choosing one.
When selecting a bone-graft substitute, match the material's proven mechanism to the healing environment: osteoconductive substitutes are appropriate for contained metaphyseal defects but insufficient for posterolateral spine fusion, which requires osteoinductive capacity.
Treat DBM and platelet-gel products with particular skepticism — their regulatory classification as 'tissue' means clinical use can precede rigorous efficacy data.