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A New Recommendation for Handling and Care of Human Allogenic Bone Graft (at Siriraj Hospital) to Reduce Post-Operative Complication

Saranatra Waikakul MD*, Thanyawan Aresanasuwan BSc*, Sahachat Makadilog Dip. MST*, Jirapa Playlex BSc*, Rathathai Maungtham BSc*, Youngyudh Vajaradul MD*

Affiliation : * Bangkok Biomaterial Center, Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

Background : Bangkok Biomaterial Center is the only allogenic bone bank in Thailand, supplying the bones to all medical centers. From a report, a certain number of post-operative complications were found.
Objective : To compare pre-protocol revision and post-protocol revision success rates and complications associated with the use of allogenic bone grafts relative to perioperative handling and care of allogenic bone. Material and Method: This retrospective comparative study was conducted at the Bangkok Biomaterial Center, Faculty of Medicine Siriraj Hospital, Mahidol University. All registration forms and surgical follow-up reports relating to the use allogenic bones procured from our bone bank between 2005 and 2015 were reviewed. New recommendations for the use of our allogenic bones were established in 2009. Results and complications after allogenic bone transplantation between 2005 and 2008 were compared with results and complications after transplantation to a new protocol between 2009 and 2015. Descriptive analysis and analysis of variance were used to evaluate the data.
Results : Data of 825 patients who underwent deep frozen allogenic bone transplantation and 1,541 patients who underwent freeze-dried allogenic bone transplantation were retrospectively reviewed. Overall, the complication rate was reduced from 14.83% in the pre-protocol revision period to 5.15% in the period after the new recommendations for perioperative graft handling were established and implemented.
Conclusion : New recommendations for the handling and care of allogenic bone during the perioperative period significantly reduced post-operative complications in patients who received transplantation with deep frozen allogenic bone. The infection rate in patients who received allogenic bone graft was very low.

Keywords : Bone, Bone banks, Allogenic bone, Bone transplantation


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