Bone bank DNB Ortho exam question - DNB Orthopaedics MS Orthopedics MRCS Exam GUIDE -

DNB Orthopaedics  MS Orthopedics  MRCS Exam GUIDE -

Orthopaedic Guidance for DNB Orthopaedics,MS Orthopaedics and Mrcs exams.Cme courses for orthopaedic surgeons.Davangere notes,solved question papers.DNB Ortho,MS Ortho MRCS,Exam Guide videos and notes 9087747888


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Tuesday 27 June 2017

Bone bank DNB Ortho exam question


  • gold standard is still autogenous bone graft – use of preserved allogenic bone graft is still controversial
    • still advantages of allogenic over autogenic is
      • no donor site morbidity, blood loss
      • unlimited volume of graft
      • from any bone – better structural property
      • can be processed in variety of structural forms
  • bone bank system : to provide on demand grafts which is sterile, non immunogenic, retaining biological and biochemical properties

Donor screening
  • donors : cadavers or live donors
  • screened for infectious diseases, malignancy, autoimmune diseases, major systemic illness
  • death d/t unknown cause avoided
  • ideal donor : healthy adult <55 yrs
Procurement of tissue
  • cadaveric tissue : within 24 hrs of death
  • live donors who under go surgical procedures or amputation
Tissue processing
  • procedure
  • screening
  • placed in saline at 600C for 3 hrs
  • bone pieces washed free of blood and marrow using jet lavage
  • placed in 70% ethanol – to remove fat
  • terminal sterilization with gamma radiation or ethylene oxide
  • freeze dried for storage
  • stored in -800C
  • kept in polyethylene sleeve
  • issued after all sterility test and culture report negative
  • fresh frozen bone stronger and better structural graft than freeze dried bone
Chance of disease transmission
  • HIV transmission is a concern
  • screening mandatory
  • preferable to do a second test to take care of window period
  • removal of blood, freeze drying, ethanol, irradiation : all make risk to nil
Immunogenicity of bone allograft
  • no tissue typing needed : removal of blood, freeze drying, irradiation
Uses of allograft
  • segmental defects
  • tumor defects
  • osteotomy wedges
  • revision THR and TKR
  • spinal fusion
Dis adv
  • time and source needed for screening, processing, distribution
  • donor to donor variation in quality
  • risk of bacterial or viral infections
  • cost

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