The Uses of Banked Bone Allograft for Non-oncological Orthopaedic Surgeries: A Preliminary Report of the First 28 Cases in Nigeria.

Abstract

Background: The use of bone allograft in Orthopaedics is a novel practice but the detailed information about the indications and outcomes is yet to be reported in Nigeria.

Objective: To highlight the non-oncological indications and early outcomes of the uses of irradiated frozen bone allografts for orthopaedic procedures in Nigeria.

Materials and methods: This was a prospective study of patients who had bone allograft implanted between 1st September 2020 and 31st August 2022 for various non-oncological orthopaedic conditions at our tertiary center. The donors were selected based on American Association of Tissue Bank (AATB) guidelines. The bone allografts were prepared, irradiated, and stored in a freezer at - 80 °C. Ethical clearance was obtained from the institutional ethics committee and written informed consent was signed by patients. They all had implantation of banked femoral head allograft. The details on demographics, indications, and early outcomes were documented in a questionnaire and analyzed with SPSS software version 20.

Results: A total of 28 patients with follow-up results were included in the study. The follow-up duration was a minimum of 1 year. The male-to-female ratio was 2.5: 1 with mean age of 51.0 ± 9.8 years. The indications were acetabular reconstruction in complex primary and revision total hip replacement (67.9%), non-union fractures (14.3%), tibial plateau fractures (10.7%), and spinal fusion surgery (7.1%). Most of the grafts were implanted as structural grafts (57.9%) while others were used as either morselized (26.3%) or composite grafts (15.8%). The mean incorporation time of 6.2 ± 0.7 months was recorded. Most of the patients (92.9%) had satisfactory osteo-integration of the graft (Oswestry's ≥ 2). There was no incidence of infection in this early report.

Conclusion: The use of deep frozen and irradiated bone allografts in the management of non-oncological orthopaedic conditions is a new development in Nigeria. This preliminary report is encouraging and we hope to arrive at a definite conclusion after a long-term follow-up.