Musculoskeletal Tissue Banks Research Articles

Allografts use in orthopedic surgery: trend change over the past 11years from a regional tissue bank.

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 11years, uniformly in terms of tissue type, except for the noticeable increase in ligamentous tissue.

Challenges of Implementing a Human Multi-Tissue Bank in a Public Hospital in the Interior of São Paulo: Under the Light of the Quality Management System

Human multi-tissue banks (HMTB) are important health institutions specialized in the capture, processing, and distribution of human tissues for transplants and research, aiming for safety and quality in the supply of their products, intended for reconstructive surgeries and injury repair, in addition to contributing to the advancement of research developed in regenerative medicine. This study aims to report and share the experience of implementing an HMTB, as well as creating an institution's own quality management system. This is a descriptive study, an experience report type, which identifies historical aspects of an HMTB's actions in the 5 years of implementing and operating the service. Initially, a musculoskeletal tissue bank was established in collaboration with the Department of Orthopedics at the State University of Campinas, São Paulo, Brazil, in June 2018. In 2023, through a management model and associated technologies, the banks of human musculoskeletal and ocular tissues at the institution established the HC-UNICAMP Human Multi-tissue Bank. The implementation of the HMTB with modern and technological infrastructure, associated with the development and operation of the quality management system, allowed us to provide excellent organization of work processes, as well as obtain the necessary health license to begin activities. It is believed that this report can be an important source of information and recommendations applicable to the implementation of other human HMTBs.

Experience with Tissue Bank Services in 2014 and 2020 in Turku, Finland

The objective of a musculoskeletal tissue bank is to collect, test, store, and provide musculoskeletal tissue allografts required in orthopedic procedures. Strict exclusion criteria are followed when selecting suitable cadaver musculoskeletal tissue donors, and the allografts are procured under sterile conditions to avoid bacterial contamination. Tissue banking in Turku, Finland, began in 1972, and tissue bank services were last reviewed in 2003. This study aimed to review the operation of the musculoskeletal tissue bank in Turku, Finland, between 2014 and 2020 and to analyze the number, types, and contamination rate of the allografts procured from the cadaver donors. Potential donor-related factors causing bacterial contamination of the allografts and whether potential musculoskeletal tissue donors were overlooked among multiorgan donors were also studied. A retrospective review of all cadaver musculoskeletal tissue donors used in the Hospital District of Southwest Finland Tyks Orto Musculoskeletal Tissue Bank during the study period was conducted, and data on the procured allograft was collected and presented. The donors were selected among patients treated in the intensive care unit (ICU) of Turku University Hospital (TYKS). A total of 28 cadaver donors were used, and 636 allografts were procured between 2014 and 2020. The bacterial contamination rate was 2.5%, which was lower than that in the previous international literature. The median treatment time in the ICU was significantly longer, and the median value of the highest C-reactive protein level was significantly higher in the group of donors with positive allograft bacterial cultures. The bacterial contamination rate in the tissue bank was low on an international scale. Some suitable musculoskeletal tissue donors were overlooked among multiorgan donors.

It's the Biology Orthopods! Heralding a Reconstructive Revolution Through Musculoskeletal Tissue Banks (MSTB) in India.

A tissue bank is an establishment that aids in retrieval, processing, storage, and distribution of human tissue for transplantation. For many years, such banks have been dispensing tissue to orthopaedic surgeons, performing reconstructive surgeries. The retrieval, preparation, and delivery of musculoskeletal tissue used for transplantation is an intricate process involving varying practices among different musculoskeletal tissue banks. Musculoskeletal allografts are used in various orthopaedic surgeries ranging from primary bone defects, trauma, and carcinoma to congenital disabilities. Every decade brings in paradigm shifts and new hope for treating challenging cases with the aid of newer devices and materials. This review article outlines various technical, regulatory and quality enhancement steps involved in tissue banking. Also, it discusses the road ahead and the research avenues for developing novel allograft products with the synergy of tissue banks and clinicians. The online version contains supplementary material available at 10.1007/s43465-022-00661-0.

Infection and utilization rates of bone allografts in a hospital-based musculoskeletal tissue bank in north India

BackgroundThe bone bank unit of interest in this article was established in January 2018, in a tertiary care teaching institute of north India. Aim of this article is to describe the sources of allografts obtained, discard rates of allografts and infection rates in the recipients after use. Material and methodsAll the relevant details of donors and recipients were maintained, and donors were screened for standard inclusion and exclusion criteria before obtaining the grafts. Aerobic culture was performed before storage and just prior to use. Samples with incomplete documentation, incomplete donor screening or positive cultures were discarded. Data on surgical site infection in recipients was collected from hospital records retrospectively. Initially ELISA based serological tests were used for screening. Donor has to undergo these tests again after 6 months to account for the window period of proliferation of viruses. Nucleic acid amplification tests (NAAT) for these viral agents were introduced in the hospital in May 2018. ResultsAllografts from a total of 196 donors were obtained in the bone bank over 2 years. Major source of bone was femoral heads harvested during total hip arthroplasty or hemi-arthroplasty. 44(22.4%) grafts had to be discarded. 95 allografts were used in 88 patients during this time. Most common indication for use was surgery for bone tumors (40%), followed by complex primary or revision arthroplasty (30.5%). Three (3.4%) recipients developed deep infection postoperatively. ConclusionFrozen allograft bone from hospital based bone banks is a reliable source of allografts. When meticulous precautions for sterility are followed, risk of infection is low. Monitoring of such bone banks should fall within a framework of the local legislature. Incomplete documentation is the major reason for wastage of the samples obtained. NAAT may be useful in screening of donors, as it reduces the wastage and the holding time of the allografts.

Situacion actual de los bancos de tejidos en colombia: tejido osteomuscular

BackgroundThe bone is the second most transplanted tissue in humans. Orthopaedists and Dentists are the main professionals that use it in their procedures. The aim of this study was to describe the activity of the certified musculoskeletal tissue banks in Colombia. MethodologyThe extraction, processing, storage, distribution, and production capacity of musculoskeletal tissues donated to each Tissue Bank were evaluated using a questionnaire completed via teleconference. The information was supplemented with records of management certification of Good Practices, Invima registers, and information provided by the NHI (Colombian National Health Institute) statistics reported by tissue banks each month. ResultsThe processed tissue comes from forensic donors (77%), IPS health care institutions (5%), and 17% from living donors. Donor age was 45 to 70 years, depending on whether it was structural tissue, gender, and condition of live / dead donor. Technologies for microbiological control varied, with aseptic processing, antibiotics, and gamma radiation being found. The final products offered are fresh tissue, lyophilised, pulverised, decalcified, and demineralized bone matrix. The maximum storage period found was 5 years. It is estimated that 67 tissue units could be obtained from each donor in Colombia. DiscussionTechnological development of Colombian musculoskeletal Tissue Banks is of the highest international standards, being able to meet the varied demand for domestic products necessary for all related medical fields. However, it was identified that there was a lag in the distribution process, as well as in usability and taking advantage of the availability, and use of tissues from donors.Evidence Level: IV

Analysis of the order-implantation relationship for musculoskeletal tissue transplantation

ObjectiveTo analyze orders requested from a musculoskeletal tissue bank and to evaluate the percentage of tissue implantation. Material and methodsTwo hundred and sixty-five orders for musculoskeletal tissue were analyzed over the course of a year. Exclusions: 5 duplications and 5 orders for which there was no availability to cover the need. We analyzed the number of surgeries in which the graft was finally used. ResultsOf a total of 255 orders, the graft was used in 178 (70%), and the graft was not used in 77 (30%). Of the 178 used, there was a partial refund in 23 (10%). Of the 77 orders not used, surgery was performed in 32 (13%) without the use of bank tissue, while surgery was discontinued in the remaining 45 (17%). DiscussionA non-utilization rate of 30% was identified, of which 17% was from surgery that was not performed and 13% from surgery that was performed, but the tissue was returned to the tissue bank, because it was not required. In a further 10% there was partial return of the tissue. Based on this analysis, we consider that it is important to have direct confirmation of the surgery to avoid sending tissue for discontinued surgeries, since in addition to the economic impact, the bank must ensure adequate temperature maintenance during transportation and storage in the transplantation centre, to avoid discarding said tissue if it is returned.

Análisis de la relación solicitud-implante de injerto para trasplante osteomuscular

ObjectiveTo analyze orders requested from a musculoskeletal tissue bank and to evaluate the percentage of tissue implantation. Material and methodsTwo hundred and sixty-five orders for musculoskeletal tissue were analyzed over the course of a year. Exclusions: 5 duplications and 5 orders for which there was no availability to cover the need. We analyzed the number of surgeries in which the graft was finally used. ResultsOf a total of 255 orders, the graft was used in 178 (70%), and the graft was not used in 77 (30%). Of the 178 used, there was a partial refund in 23 (10%). Of the 77 orders not used, surgery was performed in 32 (13%) without the use of bank tissue, while surgery was discontinued in the remaining 45 (17%). DiscussionA non-utilization rate of 30% was identified, of which 17% was from surgery that was not performed and 13% from surgery that was performed, but the tissue was returned to the tissue bank, because it was not required. In a further 10% there was partial return of the tissue. Based on this analysis, we consider that it is important to have direct confirmation of the surgery to avoid sending tissue for discontinued surgeries, since in addition to the economic impact, the bank must ensure adequate temperature maintenance during transportation and storage in the transplantation centre, to avoid discarding said tissue if it is returned.

Presence of Cells in Fresh-Frozen Allogeneic Bone Grafts from Different Tissue Banks.

Bone replacement materials have been widely used to reconstruct atrophic jawbones. Based on previous reports demonstrating the presence of viable cells in bone blocks even after processing by musculoskeletal tissue banks for orthopedic use, the aim of this study was to evaluate the presence of cells in bone blocks from three Brazilian tissue banks for maxillary reconstructions. All samples were processed by the respective tissue banks, according to the guidelines of the Brazilian National Sanitary Surveillance Agency. Three samples were removed from each block for subsequent histological processing and stained using hematoxylin & eosin. Further evaluation included section staining by the Feulgen method and ultrastructural analysis using scanning electron microscopy (SEM). Light microscopy images from all bone samples showed presence of osteocyte-like cells in all groups and intense Feulgen staining, demonstrating presence of DNA in bone even after tissue processing. The ultrastructural analysis showed red blood cells in lacunae within the bone tissue. In conclusion, despite bone tissue processing by the musculoskeletal tissue banks, cells may be found within the bone used for allogeneic grafts.

Prevalence of microbiological markers in bone tissue from live and cadaver donors in the musculoskeletal tissue bank of Passo Fundo

ObjectiveTo conduct an epidemiological analysis on the main microbiological markers in bone tissue that was processed at the musculoskeletal tissue bank of Hospital São Vicente de Paulo, in Passo Fundo, between August 2007 and October 2011. MethodsBetween August 2007 and October 2011, 202 musculoskeletal tissue samples were collected for the tissue bank. Among these, 159 samples were from living donor patients and 43 were from cadaver donors. The following serological tests were requested: hepatitis B, hepatitis C, syphilis, cytomegalovirus, Chagas disease, toxoplasmosis, HIV and HTLV. ResultsAmong the 159 living donors, 103 (64.75%) were men and 56 (35.25%) were women. The patients’ mean age was 59.35±8.87 years. Out of this total, 76 tissue samples (47.8%) from donors were rejected. There was no difference in the number of rejections in relation to sex (p=0.135) or age (p=0.523). The main cause of rejection was serologically positive findings for the hepatitis B virus, which was responsible for 48 rejections (63.15%). Among the 43 cadaver donors, the mean age was 37.84±10.32 years. Of these, 27 (62.8%) were men and 16 (37.2%) were women. Six of the samples collected from cadaver donors were rejected (13.9%), and the main cause of rejection was serologically positive findings for the hepatitis C virus, which was responsible for three cases (50%). There was no significant difference in the number of rejections in relation to sex (p=0.21) or age (p=0.252). ConclusionThere were a greater number of rejections of tissues from living donors (47.8%) than from cadaver donors (13.9%). Among the living donors, the main cause of rejection was the presence of serologically positive findings of the hepatitis B virus, while among the cadaver donors, it was due to the hepatitis C virus.

Prevalência de marcadores microbiológicos em tecido ósseo de doadores e cadáveres do Banco de Tecidos Musculoesqueléticos de Passo Fundo

Objectiveto conduct an epidemiological analysis on the main microbiological markers in bone tissue that was processed at the musculoskeletal tissue bank of Hospital São Vicente de Paulo, in Passo Fundo, between August 2007 and October 2011. Methodsbetween August 2007 and October 2011, 202 musculoskeletal tissue samples were collected for the tissue bank. Among these, 159 samples were from living donor patients and 43 were from cadaver donors. The following serological tests were requested: hepatitis B, hepatitis C, syphilis, cytomegalovirus, Chagas disease, toxoplasmosis, HIV and HTLV. Resultsamong the 159 living donors, 103 (64.75%) were male and 56 (35.25%) were female. The patients’ mean age was 59.35±8.87 years. Out of this total, 76 tissue samples (47.8%) from donors were rejected. There was no difference in the number of rejections in relation to sex (p=0.135) or age (p=0.523). The main cause of rejection was serologically positive findings for the hepatitis B virus, which was responsible for 48 rejections (63.15%). Among the 43 cadaver donors, the mean age was 37.84±10.32 years. Of these, 27 (62.8%) were male and 16 (37.2%) were female. Six of the samples collected from cadaver donors were rejected (13.9%), and the main cause of rejection was serologically positive findings for the hepatitis C virus, which was responsible for three cases (50%). There was no significant difference in the number of rejections in relation to sex (p=0.21) or age (p=0.252). Conclusionthere was a greater number of rejections of tissues from living donors (47.8%) than from cadaver donors (13.9%). Among the living donors, the main cause of rejection was the presence of serologically positive findings of the hepatitis B virus, while among the cadaver donors, it was due to the hepatitis C virus.

Homologous structural graft for treatment of bone defect during knee revision arthroplasty

ObjectiveObtaining stable bone-implant interface, correct alignment of the components, proper balance of soft tissues’ tension, maintenance of proper joint interline are fundamental principles for success in surgical revision total knee arthroplasty, which are only obtained with management bone deficiency. However, proper treatment of large defects remains unclear. The aim of this study was to evaluate the clinical and radiographic results of patients that had underwent revision surgery for total knee arthroplasty with use of structural grafts of musculoskeletal tissue bank in the period between January 2002 to December 2010 by the Knee Surgery Center of National Institute of Traumatology and Orthopaedics (INTO). The study included 26 revision arthroplasties with homologous structural bone grafting in 25 patients. Thirty-four structural bone grafts were used during the 26 revision total knee arthroplasty surgeries studied. The proximal tibia and distal femur were the grafts most frequently used. Six patients developed deep infection and in one of them with damage to the extensor mechanism associated. The average score on the WOMAC was 24,9. In the assessment of functional capacity in the SF-36, the average was 52.5. In radiographic evaluation, resorption of the graft occurred in three patients and no cases were observed of osteolysis, fracture of the graft, migration or subsidence of the components. Bone grafting of a musculoskeletal tissue bank is a satisfactory option to the handling of the bone defect in the setting of revision surgery for total knee arthroplasty.

Enxerto homólogo estrutural para tratamento do defeito ósseo durante artroplastia de revisão do joelho

ObjectiveObtaining stable bone-implant interface, correct alignment of the components, proper balance of soft tissues’ tension, maintenance of proper joint interline are fundamental principles for success in surgical revision total knee arthroplasty, which are only obtained with management bone deficiency. However, proper treatment of large defects remains unclear. The aim of this study was to evaluate the clinical and radiographic results of patients that had underwent revision surgery for total knee arthroplasty with use of structural grafts of musculoskeletal tissue bank in the period between January 2002 to December 2010 by the Knee Surgery Center of National Institute of Traumatology and Orthopaedics (INTO). The study included 26 revision arthroplasties with homologous structural bone grafting in 25 patients. Thirty-four structural bone grafts were used during the 26 revision total knee arthroplasty surgeries studied. The proximal tibia and distal femur were the grafts most frequently used. Six patients developed deep infection and in one of them with damage to the extensor mechanism associated. The average score on the WOMAC was 24,9. In the assessment of functional capacity in the SF-36, the average was 52.5. In radiographic evaluation, resorption of the graft occurred in three patients and no cases were observed of osteolysis, fracture of the graft, migration or subsidence of the components. Bone grafting of a musculoskeletal tissue bank is a satisfactory option to the handling of the bone defect in the setting of revision surgery for total knee arthroplasty.

Zulassung einer lokalen Knochenbank nach § 20 b und c AMG und Einführung einer Thermodesinfektion: Lohnt sich der Aufwand?

The German tissue law creates a different and more difficult situation for German musculoskeletal tissue banks. The objective aim of the new regulations was an increased safety and a reduction of viral and non-viral disease transmissions. In the authors' case, the government officials demanded a thermodisinfection for human femur heads. As a consequence of the requirements we aimed at an analysis of the cost-effectiveness of an admission according to § 20 b and c "Arzneimittelgesetz" (AMG) and implementation of the "lobator bonebank system™". We calculated the working hour requirements for all medical staff involved in the tissue procedure. Additional costs were the current consumptions of two freezers (cooling power - 80 °C) for one year, the current consumption of one thermodisinfection process, the material cost of one disinfection and documentation set, expenses for laboratory examinations and the non-recurrent expenses for the admission according to § 20 b and c AMG and the "lobator bonebank system". Non-recurrent expenses were calculated for five years according to 610 tissue donations. We compared the overall costs for one processed femur head with the charges of an industrial chemical treating and irradiation. Expenses for medical doctors were 14.13 € and for nurses 3.71 €. Energy costs were 15.20 € for each stored femur head. Costs for the disinfection and documentation sets were 105.15 €, laboratory expenses were 107.25 €. The non-recurring fee for the admission according to § 20 b and c AMG was 2650 €, the cost for the lobator-sd2 was 12 495 €. The overall expenses for one disinfected femur head were 274.82 € compared to 535.23 € in a tissue service. To comply with legal requirements, operating expenses of the new tissue act increased. Nevertheless we could still prove the cost-effectiveness of a local bone bank in Germany.

Musculoskeletal Tissue Banking: in Orthopaedic Perspective

Tissue bank is an establishment that collects, harvests, stores and delivers human tissue for the purposes of future use in transplant and medical research. For many years, such banks are dispensing tissue to the orthopaedic area, which has been using reconstructive techniques with allografts. The harvesting, preparation, and delivery of musculoskeletal tissue used for transplantation is an intricate process coupled with varying practices among different musculoskeletal tissue banks. Musculoskeletal allografts are used in a wide variety of orthopaedic surgeries ranging from primary bone defects, trauma, and carcinoma to congenital defects. Tissue banking guidelines andpolicies need to be specific and effective in minimizingpotential harms to donors, donor families, as well as to future tissue research and product development.All tissue bank policies and procedures for donor screening, serologic and microbiologic testing should meet current standards and regulations established by the American Association of Tissue Banks (AATB) and the United States Food and Drug Administration (FDA). The musculoskeletal banks should follow the improvement of the patient care, trauma elimination, morbidity associated with secondary surgical procedures, reduction of the prolonged hospital stays etc. This article provides the reader with information on current standards and practices in

Bacteriology laboratories and musculoskeletal tissue banks in Australia

In Australia, there are six Therapeutic Goods Administration-licensed clinical bacteriology laboratories providing bacterial and fungal bioburden testing of allograft musculoskeletal samples sent from 10 tissue banks. Musculoskeletal swab and/or tissue biopsy samples are collected at the time of allograft retrieval and sent to bacteriology laboratories for bioburden testing, in some cases requiring interstate transport. Bacteria and fungi may be present within the allograft at the time of retrieval or contaminated from an external source. The type of organism recovered will determine if the allograft is rejected for transplant, which may include all allografts from the same donor. Bacteriology staff also provides unpaid support of tissue banks through meeting involvement, consultations, licence-related activities, validations and research funded by their organisation and not part of any contractual agreement. Bacteriology laboratories and tissue banks must be compliant to the Code of Good Manufacturing Practice - Human Blood and Tissues and regulated by the Therapeutic Goods Administration. Clinical bacteriology laboratories also require mandatory accreditation to Standards Australia International Organisation for Standardisation (ISO) 15189:2009 medical laboratories - particular requirements for quality and competence, and may also attain Standards Australia/New Zealand Standard ISO 9001:2000 quality management systems certification. Bacteriology laboratories and musculoskeletal tissue banks are integral partners in providing safe allograft musculoskeletal tissue for transplant.

Fresh-frozen human bone allograft in vertical ridge augmentation: clinical and tomographic evaluation of bone formation and resorption

The aim of the current study is to evaluate fresh-frozen human bone allografts (FHBAs) used in vertical ridge augmentation clinically and by computed tomography, and to analyze the resulting bone formation and graft resorption. Sixteen FHBAs were grafted in the maxillae and mandibles of 9 patients. The FHBAs, which were provided by the Musculoskeletal Tissue Bank of Marilia Hospital (Unioss), were frozen at -80°C. After 7months, dental implants were placed and bone parameters were evaluated. Vertical bone formation was measured by computerized tomography before (T0) and at 7months (T1) after the surgical procedure. Bone graft resorption was measured clinically from a landmark screw head using a periodontal probe. The results were analyzed by Student's t-test. Significant differences existed in the bone formation values at T0 and T1, with an average change of 4.03±1.69mm. Bone graft resorption values were 1.0±0.82mm (20%). Implants were placed with varying insertion torque values (35-45Ncm), and achieved primary stability. This study demonstrates that FHBAs promote satisfactory vertical bone formation with a low resorption rates, good density, and primary implant stability.

Major bone defect treatment with an osteoconductive bone substitute

A bone defect can be provoked by several pathological conditions (e.g. bone tumours, infections, major trauma with bone stock loss) or by surgical procedures, required for the appropriate treatment. Surgical techniques currently used for treating bone defects may count on different alternatives, including autologous vascularized bone grafts, homologous bone graft provided by musculoskeletal tissue bank, heterologous bone graft (xenograft), or prostheses, each one of them dealing with both specific advantages and complications and drawbacks. The main concerns related to these techniques respectively are: donor site morbidity and limited available amount; possible immune response and viral transmission; possible animal-derived pathogen transmission and risk of immunogenic rejection; high invasiveness and surgery-related systemic risks, long post-operative. physical recovery and prostheses revision need. Nowadays, an ideal alternative is the use of osteoconductive synthetic bone substitutes. Many synthetic substitutes are available, used either alone or in combination with other bone graft. Synthetic bone graft materials available as alternatives to autogeneous bone include calcium sulphates, special glass ceramics (bioactive glasses) and calcium phosphates (calcium hydroxyapatite, HA; tricalcium phosphate, TCP; and biphasic calcium phosphate, BCP). These materials differ in composition and physical properties fro each other and from bone (De Groot in Bioceramics of calcium phosphate, pp 100-114, 1983; Hench in J Am Ceram Soc 74:1487-1510, 1994; Jarcho in Clin Orthop 157:259-278, 1981; Daculsi et al. in Int Rev Cytol 172:129-191, 1996). Both stoichiometric and non-stoichiometric HA-based substitutes represent the current first choice in orthopedic surgery, in that they provide an osteoconductive scaffold to which chemotactic, circulating proteins and cells (e.g. mesenchymal stem cells, osteoinductive growth factors) can migrate and adhere, and within which progenitor cells can differentiate into functioning osteoblasts (Szpalski and Gunzburg in Orthopedics 25S:601-609, 2002). Indeed, HA may be extemporarily combined either with whole autologous bone marrow or PRP (platelet rich plasma) gel inside surgical theatre in order to favour and accelerate bone regeneration. A case of bifocal ulnar bone defect treated with stoichiometric HA-based bone substitute combined with PRP is reported in here, with a 12-month-radiographic follow-up.

Radiological assessment of bone segments for transplantation: experience at Rizzoli Orthopedic Institute

Aim: This study aimed to analyze results obtained from radiological assessment of skeletal segments stored in the musculoskeletal tissue bank at Rizzoli Orthopedic Institute.

Radiological assessment of bone segments for transplantation: Experience at Rizzoli Orthopedic Institute

Aim To analyse results obtained from radiological assessment of skeletal segments stored in the musculoskeletal tissue bank (MTB) at Rizzoli Orthopaedic Institute. Materials and methods Between January 1997 and June 2003, 891 bone segments underwent radiographic examination in two views. Two hundred and thirteen of these segments were examined by a radiologist between July 2002 and June 2003. Diagnostic evaluation was aimed at recognising relevant degenerative, traumatic and focal lesions. Focal lesions underwent histological tests. Results Twenty-two lytic lesions were found in 12 segments. Ten of these were studied between July 2002 and June 2003 and two in the period before specialist radiological assessment. In the latter cases the lesions were identified by the orthopedic specialist who had examined the X-rays before planning surgery. Histological tests showed that the bone tissue was normal or involved by degenerative phenomena. Conclusions We think donor screening should include radiological assessment of bone segments, performed according to standard parameters by a radiologist to identify bone lesions that may jeopardise the successful outcome of surgery.