Abstract
Allografts are the second most transplanted tissue in medicine after blood and are now increasingly used for both primary and revision surgery. Allografts have the advantages of lower donor site morbidity, availability of multiple grafts, and shorter operative time. The Banks represents the bridge between Donor and Recipient and guarantees the quality and safety of the distributed allografts Given the increasing interest in these tissues, a retrospective analysis of data collected from the Regional Musculoskeletal Tissue Bank registry over an 11-year period (2009–2019) was conducted. The statistical analyses used were the Shapiro–Wilk normality test and a Poisson regression model. From January 2009 to December 2019, a total of 14,199 musculoskeletal tissues stored in the Regional Musculoskeletal Tissue Bank were provided for surgical allograft procedures. In 2009, the number of allografts performed was 925; this figure has steadily increased to 1599 in 2019. Epiphyses were taken as the reference tissue with an almost constant trend over the period, while a significant increase was denoted for extensor mechanism allograft, ligaments, tendons and long bone corticals (p < 0.001), processed bone tissues had no change in trend (p = 0.841). There was also a gradual decrease in the rate of microbiological positivity, as determined by bacteriological and serological tests performed on the collected tissues. This phenomenon is due to improved sampling techniques and the training of a dedicated team. Thus, we have seen how the use of allografts in orthopedic surgery has increased over the past 11 years, uniformly in terms of tissue type, except for the noticeable increase in ligamentous tissue.
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References
Al-Mohrej O, Al Dera H (2015) Physiological principles that promote bone regeneration and repair during the application of ilizarov procedure. Sci Adv Mater 7:2134–2146. https://doi.org/10.1166/sam.2015.2639
Baldwin P, Li DJ, Auston DA et al (2019) Autograft, allograft, and bone graft substitutes: clinical evidence and indications for use in the setting of orthopaedic trauma surgery. J Orthop Trauma 33:203–213. https://doi.org/10.1097/BOT.0000000000001420
Burchardt H (1983) The biology of bone graft repair. Clin Orthop Relat Res Apr 174:28-42
Busch A, Wegner A, Haversath M, Jäger M (2021) Bone substitutes in orthopaedic surgery: current status and future perspectives. Z Orthop Unfall 159:304–313. https://doi.org/10.1055/a-1073-8473
Chahbouni M, Rami A, Morhit ME et al (2018) Creation of the bone bank of the Rabat and Casablanca region in Morocco. Pan Afr Med J 29:210
Coetzee JC, Den Hartog BD, Stone McGaver R et al (2021) Femoral head allografts for talar body defects. Foot Ankle Int 42:815–823. https://doi.org/10.1177/1071100720983811
Condello V, Zdanowicz U, Di Matteo B et al (2019) Allograft tendons are a safe and effective option for revision ACL reconstruction: a clinical review. Knee Surg Sports Traumatol Arthrosc 27:1771–1781. https://doi.org/10.1007/s00167-018-5147-4
Cypher TJ, Grossman JP (1996) Biological principles of bone graft healing. J Foot Ankle Surg 35:413–417. https://doi.org/10.1016/s1067-2516(96)80061-5
Dasari SP, Kerzner B, Fortier LM et al (2022) Improved outcomes for proximal humerus fracture open reduction internal fixation augmented with a fibular allograft in elderly patients: a systematic review and meta-analysis. J Shoulder Elbow Surg 31:884–894. https://doi.org/10.1016/j.jse.2021.11.004
Drampalos E, Fadulelmola A, Mohammed R et al (2017) Nine-year results of whole femoral head allograft with articular cartilage for acetabular impaction grafting in revision hip replacement. Ann R Coll Surg Engl 99:203–206. https://doi.org/10.1308/rcsann.2016.0316
Finkemeier CG (2002) Bone-grafting and bone-graft substitutes. J Bone Joint Surg Am 84:454–464. https://doi.org/10.2106/00004623-200203000-00020
Friedlaender GE (1987) Bone banking: In support of reconstructive surgery of the hip. Clin Orthop Relat Res Dec 225:17-21
Gasser S, Uppal R (2006) Anterior cruciate ligament reconstruction: a new technique for Achilles tendon allograft preparation. Arthroscopy 22:1365.e1–3. https://doi.org/10.1016/j.arthro.2006.05.031
Getgood A, Bollen S (2010) What tissue bankers should know about the use of allograft tendons and cartilage in orthopaedics. Cell Tissue Bank 11:87–97. https://doi.org/10.1007/s10561-009-9129-0
Gilat R, Cole BJ (2020) Meniscal allograft transplantation: indications, techniques, outcomes. Arthroscopy 36:938–939. https://doi.org/10.1016/j.arthro.2020.01.025
Hulet C, Sonnery-Cottet B, Stevenson C et al (2019) The use of allograft tendons in primary ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 27:1754–1770. https://doi.org/10.1007/s00167-019-05440-3
Ilyas I, Alrumaih H, Rabbani S (2017) Freeze dried proximal femoral allografts in revision of femoral stems. J Arthroplasty 32:171–176. https://doi.org/10.1016/j.arth.2016.06.016
Ilyas I, Al-Rabiah AM, Alhussainan TS et al (2021) Principles of bone and tissue banking in Saudi Arabia: 10-year experience report. Cell Tissue Bank 22:93–101. https://doi.org/10.1007/s10561-020-09868-7
Jackson DW, Grood ES, Goldstein JD et al (1993) A comparison of patellar tendon autograft and allograft used for anterior cruciate ligament reconstruction in the goat model. Am J Sports Med 21:176–185. https://doi.org/10.1177/036354659302100203
Kainer MA, Linden JV, Whaley DN et al (2004) Clostridium infections associated with musculoskeletal-tissue allografts. N Engl J Med 350:2564–2571. https://doi.org/10.1056/NEJMoa023222
Kim Y-K, Kang S-W, Jung K-H, Oh Y-K (2022) The potential of locking plate with intramedullary fibular allograft to manage proximal humeral fracture with an unstable medial column. Arch Orthop Trauma Surg 142:91–97. https://doi.org/10.1007/s00402-020-03604-2
Kreuz FP, Hyatt GW, Turner TC, Bassett AL (1951) The preservation and clinical use of freeze-dried bone. JBJS 33:863
Liu Q, He H, Duan Z et al (2020) intercalary allograft to reconstruct large-segment diaphysis defects after resection of lower extremity malignant bone tumor. Cancer Manag Res 12:4299–4308. https://doi.org/10.2147/CMAR.S257564
Maletis GB, Inacio MCS, Funahashi TT (2013) Analysis of 16,192 anterior cruciate ligament reconstructions from a community-based registry. Am J Sports Med 41:2090–2098. https://doi.org/10.1177/0363546513493589
McAllister DR, Joyce MJ, Mann BJ, Vangsness CT (2007) Allograft update: the current status of tissue regulation, procurement, processing, and sterilization. Am J Sports Med 35:2148–2158. https://doi.org/10.1177/0363546507308936
Molenaars RJ, Schoolmeesters BJA, Viveen J et al (2019) There is a role for allografts in reconstructive surgery of the elbow and forearm. Knee Surg Sports Traumatol Arthrosc 27:1840–1846. https://doi.org/10.1007/s00167-018-5221-y
Mroz TE, Joyce MJ, Steinmetz MP et al (2008) Musculoskeletal allograft risks and recalls in the United States. J Am Acad Orthop Surg 16:559–565. https://doi.org/10.5435/00124635-200810000-00001
Nandi SK, Roy S, Mukherjee P et al (2010) Orthopaedic applications of bone graft & graft substitutes: a review. Indian J Med Res 132:15–30
Paterson MP, du Toit G (1989) The use of banked femoral head bone allograft in spinal surgery. S Afr J Surg 27:89–92
Poitout DG, Nouaille-de-Gorce Y (2004) Bone banks: technical aspects of the preparation and preservation of articular allografts. In: Poitout DG (ed) Biomechanics and biomaterials in orthopedics. Springer, London, pp 65–75
Rosso F, Bisicchia S, Bonasia DE, Amendola A (2015) Meniscal allograft transplantation: a systematic review. Am J Sports Med 43:998–1007. https://doi.org/10.1177/0363546514536021
Rupp M, Klute L, Baertl S et al (2022) The clinical use of bone graft substitutes in orthopedic surgery in Germany—a 10-years survey from 2008 to 2018 of 1,090,167 surgical interventions. J Biomed Mater Res B Appl Biomater 110:350–357. https://doi.org/10.1002/jbm.b.34911
Samsell B, Softic D, Qin X et al (2019) Preservation of allograft bone using a glycerol solution: a compilation of original preclinical research. Biomater Res 23:5. https://doi.org/10.1186/s40824-019-0154-1
Simonds RJ, Holmberg SD, Hurwitz RL et al (1992) Transmission of human immunodeficiency virus type 1 from a seronegative organ and tissue donor. N Engl J Med 326:726–732. https://doi.org/10.1056/NEJM199203123261102
Sorger JI, Hornicek FJ, Zavatta M et al (2001) Allograft fractures revisited. Clin Orthop Relat Res. https://doi.org/10.1097/00003086-200101000-00011
Stevenson S (1999) Biology of bone grafts. Orthop Clin North Am 30:543–552. https://doi.org/10.1016/s0030-5898(05)70107-3
Urrutia J, Molina M (2013) Fresh-frozen femoral head allograft as lumbar interbody graft material allows high fusion rate without subsidence. Orthop Traumatol Surg Res 99:413–418. https://doi.org/10.1016/j.otsr.2013.03.010
Wang J-W, Hsu C-H, Huang C-C et al (2013) Reconstruction using femoral head allograft in revision total knee replacement: an experience in Asian patients. Bone Joint J 95-B:643–648. https://doi.org/10.1302/0301-620X.95B5.29915
Yu D, Panesar PS, Delman C et al (2022) Comparing fusion rates between fresh-frozen and freeze-dried allografts in anterior cervical discectomy and fusion. World Neurosurg X 16:100126. https://doi.org/10.1016/j.wnsx.2022.100126
Zhang M, Matinlinna JP, Tsoi JKH et al (2020) Recent developments in biomaterials for long-bone segmental defect reconstruction: a narrative overview. J Orthop Transl 22:26–33. https://doi.org/10.1016/j.jot.2019.09.005
Zmolek JC, Dorr LD (1993) Revision total hip arthroplasty. The use of solid allograft. J Arthroplasty 8:361–370. https://doi.org/10.1016/s0883-5403(06)80034-3
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Della Valle, A., Compagnoni, R., Puglia, F. et al. Allografts use in orthopedic surgery: trend change over the past 11 years from a regional tissue bank. Cell Tissue Bank (2024). https://doi.org/10.1007/s10561-024-10134-3
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DOI: https://doi.org/10.1007/s10561-024-10134-3