Biologics

Use of bone grafts and substitutes has declined in US

Kinaci A. Orthopedics. 2014;doi:10.3928/01477447-20140825-54.

Use of bone grafts and bone graft substitutes has decreased in the United States during the past 16 years, with a slight shift from autogenous to substitute grafts, according to study findings.

Researchers collected data from the National Hospital Discharge Survey for almost 2 million patients in the United States. Using ICD-9-CM codes from 1992 to 1995, 1996 to 1999, 2000 to 2003 and 2004 to 2007, the researchers analyzed autogenous and artificial graft use. Of the nearly 2 million bone graft procedures, 83% were autogenous bone grafts and 17% were artificial.

From their analysis, the researchers found the sex of patients who underwent treatment with bone grafts shifted significantly from predominantly male to predominantly female.

Also, during the course of 15 years, mean patient age increased from 47 years to 53 years.

A significant decrease in mean length of hospital stay occurred — from 6 days to 5 days — and whereas the rate of routine discharge to home decreased, the rate of discharge to short-term or long-term care facilities increased significantly, according to the researchers.
Bone graft use decreased in both absolute number and proportion of the total U.S. population after 1999 with regard to autogenous grafts and after 2003 in terms of artificial grafts. The researchers observed a slight shift from autogenous to artificial bone graft use between the late 1990s and early 2000s.

Musculoskeletal system and connective tissue diseases, especially spinal diseases, were the largest group and subgroup in which grafts were used, according to the researchers. With the exception of dorsopathies, the main diagnoses for which grafts were commonly used did not change during the period studied.

Disclosure: The authors have no relevant financial disclosures.

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Josh Sandberg

Josh Sandberg is the President of Ortho Sales Partners and Partner for The De Angelis Group. He also serves as Co-Founder and Editor of OrthoSpineNews.

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