Bone Bank

Uses of bone allografts

• Malignant bone tumors

• Benign bone tumors

• Trauma

• Replacement surgeries

• Spine surgeries

• Sport injuries – ligament and tendon reconstruction

• Arthrodesis

• Dental surgeries

Advantages of bone allografts

• No limitation to the number / size of bone grafts

• Can be tailored intra-operatively to match the size of the defect

• It would be 5 to 10 times cheaper than a prosthesis

• Obviates long-term complications of prosthesis

• Biological reconstruction

• Soft-tissue adherence around the grafted bone

• Ligament or tendon attached

• The possibility of the concomitant use of a prosthesis

• No donor site morbidity

• Grafts from one donor can be used for 25 patients

Lyophilised bone blocks

Sterilized with 25 kilo Gray of gamma radiation. Stored at room temperature. Shelf life of 3 years.

Uses

1. Fill cavities

2. Small bone defects

3. Non-union

4. Spinal fusion

How to use

1. Wash 3 times with copious amount of saline

2. Soak in antibiotic solution for 30 minutes (Gentamycin + Vancomycin)

3. Can be shaped appropriately and used

Deep frozen femoral heads

Irradiated and non-irradiated femoral heads available. Stored at minus 80° Celsius. Shelf life of 5 years.

Uses

1. Fill cavities

2. Small bone defects

3. Non-union

4. Spinal fusion

How to use

1. Remove articular cartilage

2. Shape or cut to appropriate dimensions

3. Wash with copious amount of saline using jet lavage to remove any blood or fat remaining

4. Soak in antibiotic solution for 30 minutes (Gentamycin + Vancomycin)

Deep frozen long bones (structural allografts)

Irradiated and non-irradiated long bones available. Stored at minus 80° Celsius. Shelf life of 5 years.

Uses

1. Structural allografts to bridge bone defects

How to use

1. Remove all remaining soft tissues and periosteum

2. Ream the medulla to remove the marrow contents

3. Wash with copious amount of saline using jet lavage to remove any blood or marrow content

4. Soak in antibiotic solution for 30 minutes (Gentamycin + Vancomycin)

Source of bones

Living donors

• Bones which are otherwise discarded after hemi-replacement / total hip replacement / total knee replacement

• Bones can be harvested from amputated limbs (non-infective etiology)

Deceased donors

• Brain dead – as a part of the multi-organ transplant team

• Cadaveric – bones have to be harvested within 6 hours of death in a sterile operating theatre

Harvesting

The staff are well trained in harvesting bones from brain dead donors and in processing of bones. An ambulance exclusively for the bone bank is available and is used for harvesting bones from the brain dead.

Bone heals best with bone

Bridging a bone defect is one of the most challenging problems in surgery. It is commonly reconstructed with a mega-prosthesis, but the best method is to use bone, because bone will unite with bone tissue itself.

The cost of the alternatives

• Cost of 1 mg of bone substitute – Rs. 25,000

• Cost of a modular prosthesis – between Rs. 1,00,000 and Rs. 15,00,000

• Expensive and not affordable for many patients

• Allografts are cost-effective and biological

Very few bone banks in India

A bone bank procures, processes, stores and distributes bone. There are very few bone banks in India – among them Tata Memorial Hospital, Mumbai and M.S. Ramaiah Medical College, Bangalore.

Who will benefit

• Approximately 40–50 patients per year would benefit from the bone bank at Cancer Institute (WIA)

• Other hospitals will be able to obtain grafts from the bank

• A wide spectrum of patients with diverse conditions will benefit

• Grafts from one donor can be used for 25 patients

Together we can move mountains

And make anything possible. To learn more about bone donation or to pledge your support, contact the Bone Bank team below.

2014 – Seeds sown

Envisioned by Executive Vice-Chairman Dr. Hemanth Raj E, who supported training in the Diploma in Tissue Banking from NUH, Singapore – one year of online training with a week of demonstration and examination.

2015 – Diploma in Tissue Banking

Cleared the examination with distinction in September 2015, and visited the tissue bank at M.S. Ramaiah Medical College.

2016 – Learning from Asia Pacific bone banks

Visited bone banks in Seoul, South Korea and attended the APASTB annual conference, witnessing the wide application of bone allografts.

2019 – Bone Bank inaugurated

Equipment donated by the Rotary Club of Madras Central under their global grant project. Inaugurated on 28.06.2019, inspected by the Directorate of Medical Services on 03.08.2019, registered with the Government of Tamil Nadu on 24.09.2019 and with TRANSTAN in November 2019.

2020 – TRANSTAN visit

TRANSTAN visited the facility on 29.02.2020.

Looking ahead

• To get ISO standards

• 3D printing

• Enhance bone incorporation – allograft engineering