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The standard of care consists of bone autografts with systemic antibiotics. These injuries and treatments lead to donor site morbidity, antibiotic resistant strains of bacteria, and often end stage amputation. This study proposes an alternative to the autograft using a porous, hydroxyapatite (HA) scaffold evaluated with and without infection and antibiotics. Twenty\u2010four New Zealand white rabbits received either our HA scaffold or a pulverized autograft (PBA) within a surgically created critical\u2010sized defect in the femur. The two grafts were evaluated in either septic or aseptic defects and with or without antibiotic treatment. The HA scaffolds were characterized with micro computed tomography. Post\u2010euthanasia, micro computed tomography, histology, and white blood cells component analysis were completed. The HA had significantly greater (<jats:italic>p<\/jats:italic> &lt;\u2009.001) mineralization to total volume than the PBA groups with 27.56% and 14.88%, respectively, and the septic HA groups were significantly greater than the aseptic groups both with and without antibiotics (<jats:italic>p<\/jats:italic> =\u2009.016). The bone quality denoted by bone mineral density was also significantly greater (<jats:italic>p<\/jats:italic> &lt;\u2009.001) in the HA groups (67.01\u2009\u00b1\u20090.38 mgHA\/cm<jats:sup>3<\/jats:sup>) than the PBA groups (64.66\u2009\u00b1\u20090.85 mgHA\/cm<jats:sup>3<\/jats:sup>). The HA scaffold is a viable alternative to the bone autograft in defects with and without infection as shown by the quality and quantity of bone.<\/jats:p>","DOI":"10.1002\/jbm.b.34466","type":"journal-article","created":{"date-parts":[[2019,8,14]],"date-time":"2019-08-14T06:45:06Z","timestamp":1565765106000},"page":"1157-1166","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["In vivo hydroxyapatite scaffold performance in infected bone defects"],"prefix":"10.1002","volume":"108","author":[{"given":"Joseph J.","family":"Pearson","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering The University of Texas at San Antonio  San Antonio Texas"},{"name":"UTSA\u2010UTHSCSA Joint Graduate Program in Biomedical Engineering  San Antonio Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Gerken","sequence":"additional","affiliation":[{"name":"UTSA\u2010UTHSCSA Joint Graduate Program in Biomedical Engineering  San Antonio Texas"},{"name":"Department of Orthopaedics The University of Texas Health Science Center San Antonio  San Antonio Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunsik","family":"Bae","sequence":"additional","affiliation":[{"name":"College of Veterinary Medicine Chonnam National University  Gwangju Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyu\u2010Bok","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics Kyungpook National University  Daegu Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arpan","family":"Satsangi","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering The University of Texas at San Antonio  San Antonio Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"McBride","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Bone Tissue Engineering Center Carnegie Mellon University  Pittsburgh Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark R.","family":"Appleford","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering The University of Texas at San Antonio  San Antonio Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David D.","family":"Dean","sequence":"additional","affiliation":[{"name":"UTSA\u2010UTHSCSA Joint Graduate Program in Biomedical Engineering  San Antonio Texas"},{"name":"Department of Orthopaedics The University of Texas Health Science Center San Antonio  San Antonio Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey O.","family":"Hollinger","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Bone Tissue Engineering Center Carnegie Mellon University  Pittsburgh Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joo L.","family":"Ong","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering The University of Texas at San Antonio  San Antonio Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3218-2916","authenticated-orcid":false,"given":"Teja","family":"Guda","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering The University of Texas at San Antonio  San Antonio Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,8,13]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.5125\/jkaoms.2013.39.2.43"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10856-015-5538-8"},{"key":"e_1_2_6_4_1","volume-title":"Introduction to biomaterials: Introduction; 2. 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