BONE BANKS

Paulo Gilberto Cimbalista de Alencar, Inácio Facó Ventura Vieira, Paulo Gilberto Cimbalista de Alencar, Inácio Facó Ventura Vieira

Abstract

Bone banks are necessary for providing biological material for a series of orthopedic procedures. The growing need for musculoskeletal tissues for transplantation has been due to the development of new surgical techniques, and this has led to a situation in which a variety of hospital services have been willing to have their own source of tissue for transplantation. To increase the safety of transplanted tissues, standards for bone bank operation have been imposed by the government, which has limited the number of authorized institutions. The good performance in a bone bank depends on strict control over all stages, including: formation of well-trained harvesting teams; donor selection; conducting various tests on the tissues obtained; and strict control over the processing techniques used. Combination of these factors enables greater scope of use and numbers of recipient patients, while the incidence of tissue contamination becomes statistically insignificant, and there is traceability between donors and recipients. This paper describes technical considerations relating to how a bone bank functions, the use of grafts and orthopedic applications, the ethical issues and the main obstacles encountered.

Keywords: Allograft; Bone Banks; Bone Transplantation; Orthopedic Surgery.

Figures

Figure 1
Figure 1
Gowned team carrying out tissue processing in a sterile manner.
Figure 2
Figure 2
Harvesting in accordance with the principles of asepsis, as in large-scale orthopedic surgery.
Figure 3
Figure 3
PVC prosthesis for cadaver reconstruction.
Figure 4
Figure 4
Revision arthroplasty on the hip. A) Loosening of acetabular component with large bone failure. B) Homologous graft from distal femur, made into “7” shape. C) Late postoperative period, following acetabular reconstruction, showing evident consolidation of the graft.
Figure 5
Figure 5
Types of graft. A) Cortical “rings”, which can be used to fill wedges in osteotomy cases. B) Patellar and quadricipital tendons, for multi-ligament reconstruction. C) Osteochondral graft from the proximal tibia, for post-traumatic or post-tumor reconstructions.

References

    1. Whang PG, Wang JC. Bone graft substitutes for spinal fusion. Spine J. 2003;3(2):155–165.
    1. Vaccaro AR, Chiba K, Heller JG, Patel TCh, Thalgott JS, Truumees E. Bone grafting alternatives in spinal surgery. Spine J. 2002;2(3):206–215.
    1. Albrektsson T, Johanson C. Osteoinduction, osteoconduction and osseintegration. Eur Spine J. 2001;10(1):96–101.
    1. Bauer TW, Muschler GF. Bone graft materials. An overview of the basic science. Clin Orthop Relat Res. 2000;(371):371–377.
    1. Tomford WW. Transmission of disease through transplantation of musculoskeletal allografts. J Bone Joint Surg Am. 1995;77(11):1742–1754.
    1. Asada N, Tsuchiya H, Kitaoka K, Mori Y, Tomita K. Massive autoclaved allografts and autografts for limb salvage surgery. A 1-8 year follow-up of 23 patients. Acta Orthop Scand. 1997;68(4):392–395.
    1. Thorén K, Aspenberg P. Ethylene oxide sterilization impairs allograft incorporation in a conduction chamber. Clin Orthop Relat Res. 1995;(318):318–364.
    1. Forsell JH. Irradiation of musculoskeletal tissues. In: Tomford WW, editor. Musculoskeletal tissue banking. Raven Press; New York: 1993. pp. 149–180.
    1. Villar RN. Tissue banking. In: Villar RN, Gross AE, McMinn D, editors. Revision hip arthroplasty. A practical approach to bone stock loss. Butterworth Heineman; Oxford: 1997. pp. 26–32.
    1. Alencar PG. Revisão em artroplastia total de quadril. Banco de ossos. Clínica Ortopédica. 2001;2(4):1173–1188.
    1. Paprosky W, Laurence J, Cameron H. Femoral defect classification: clinical application. Orthop Rev. 1990;19(Suppl 9):9.
    1. Slooff TJ, Schimmel JW, Buma P. Cemented fixation with bone grafts. Orthop Clin North Am. 1993;24(4):667–677.
    1. Gie GA, Linder L, Ling RS, Simon JP, Slooff TJ, Timperley AJ. Impacted cancellous allografts and cement for revision total hip arthroplasty. J Bone Joint Surg Br. 1993;75(1):14–21.
    1. Gross AE, Lavoie MV, McDermott P, Marks P. The use of allograft bone in revision of total hip arthroplasty. Clin Orthop Relat Res. 1985;(197):197–202.
    1. Matejovsky Z, Jr, Matejovsky Z, Kofranek I. Massive allografts in tumour surgery. Int Orthop. 2006;30(6):478–483.
    1. Berven S, Tay BK, Kleinstueck FS, Bradford DS. Clinical applications of bone graft substitutes in spine surgery: consideration of mineralized and demineralized preparations and growth factor supplementation. Eur Spine J. 2001;10(Suppl 2):S169–S177.
    1. Mc Guire DA, Hendricks D. Allografts in sports medicine. Oper Tech Sports Med. 2007;15(1):46–52.
    1. Tom JA, Rodeo SA. Soft tissue allografts for knee reconstruction in sports medicine. Clin Orthop Relat Res. 2002;(402):402–456.
    1. Willian DB. Fresh osteochondral allografting. Oper Tech Sports Med. 2000;8(2):158–162.

Source: PubMed

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