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Worldwide population aging and associated with it epidemics of osteoporosis, widespread of bone and joint reconstructive surgery and first of all joint replacement lead to explosive growth of interest in bone grafting.

Although autografts are still the golden standard in bone regeneration, allogeneic bone substitutes have reached a state that allows for their application with satisfying clinical results. However, it has repeatedly been supposed that the different allogeneic materials underwent different purification processes, which modifies bone regeneration properties of these materials and also for different safety conditions. In the present publication, the treatment of the precursor tissue, the safety conditions, and the regenerative possibilities of C+TBA bone blocks based in preclinical and clinical data are described. Thus, it is described how the risks of infections and also immunological reactions becomes completely eliminated, while the special purification process allows for preservation of the native structure of the bone block. Both the in vitro studies and the clinical trials including histological follow-ups showed the optimal regeneration properties of these bone blocks. It has been shown that the allogeneic bone grafts have been integrated without causing inflammatory anomalies at the implantation site. Altogether, the allogeneic bone substitute material serves as an excellent basis for the formation of new bone. Finally, the combination of the allogeneic C+TBA bone blocks with different antibiotics is described. Interestingly, it is possible to combine the allogeneic bone substitute ether with antibiotics in the sense of prophylaxis and/or with bone marrow aspirate in order to accelerate bone remodeling.

About the authors

R. Schnettler

University Medical Center, Justus Liebig University of Giessen

Author for correspondence.

Reinhard Schnettler — MD, professor, the Head of the Trauma Surgery Department.

Klinikstrasse, 29, D-35392 Giessen


J. Franke

Elbe Klinikum


Jorg Franke — MD, the Head of the Department of Trauma and Orthopaedic Surgery, Elbe Klinikum Stade Unfallchirurgie und Orthopädie.

Stade Germany

D. Rimashevskiy

Peoples› Friendship University of Russia


Dmitry Rimashevskiy — Cand. Sci. (Med.) Associate Professor, Traumatology and Orthopedics Department.


Russian Federation

N. Zagorodniy

Peoples› Friendship University of Russia


MoscowNikolai V. Zagorodniy — Dr. Sci. (Med.), professor, the Head of Traumatology and Orthopedics Department.

Moscow Russian Federation

N. Batpenov

Scientific Research Institute of Traumatology and Orthopedics


Nurlan Batpenov — MD, Dr. Sci. (Med.), professor, director.

Astana Kazakhstan

R. E. Unger

Institute of Pathology, Johannes Gutenberg University


Ronald E. Unger — MD.

Mainz Germany

S. Wenisch

Institute of Veterinary Anatomy, Histology and Embryology, Justus Liebig University of Giessen


Sabina Wenisch — MD, Professor.



M. Barbeck

Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Charité-Universitätsmedizin Berlin; Botiss Biomaterials


Mike Barbeck — MD, Senior Researcher.

Berlin Germany


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