Current trends in bone grafting and the issue of banked bone allografts based on the fourth nationwide survey of bone grafting status from 2000 to 2004 |
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| Authors: | Ken Urabe Moritoshi Itoman Yoshiaki Toyama Yoshiaki Yanase Yukihide Iwamoto Hajime Ohgushi Mitsuo Ochi Yoshinori Takakura Yudo Hachiya Hiromi Matsuzaki Yoshitaka Matsusue Satoshi Mori |
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| Institution: | (1) Department of Orthopaedic Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Sagamihara, Kanagawa 228-8555, Japan;(2) Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo, Japan;(3) Department of Orthopaedic Surgery, Nagayoshi General Hospital, Osaka, Japan;(4) Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan;(5) Research Institute for Cell Engineering, National Institute of Advanced Industrial Science and Technology, Hyogo, Japan;(6) Department of Orthopaedic Surgery, Hiroshima University School of Medicine, Hiroshima, Japan;(7) Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan;(8) Department of Orthopaedic Surgery, Hachiya Orthopaedic Hospital, Nagoya, Japan;(9) Department of Orthopaedic Surgery, Nihon University Surugadai Hospital, Tokyo, Japan;(10) Department of Orthopaedic Surgery, Shiga University of Medical Science, Shiga, Japan;(11) Department of Orthopaedic Surgery, Kagawa University School of Medicine, Kagawa, Japan |
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| Abstract: | Background The Japanese Orthopaedic Association Committee on Tissue Transplantation and Regenerative Medicine has conducted a nationwide
survey of the status of bone grafting in Japan every 5 years from 1985. We report here the status of bone grafting from 2000
to 2004, show the trends in bone grafting from 1985 to 2004, and draw attention to the issues affecting banked bone allografts.
Methods Questionnaires devised by the Committee were sent to all educational and training hospitals (2239 institutions) approved by
the Japanese Orthopaedic Association.
Results Survey responses were obtained from 1263 institutions (56%). Of these, 875 institutions performed tissue transplantation during
this period. A total of 163 564 tissue transplantations were performed, and 134 782 (82.4%) of them were bone grafts. Of the
bone grafts, 76 015 (56.4%) were autografts, 53 735 (40%) used a synthetic bone substitute, and 4886 (3.6%) were banked bone
allografts. The proportion of synthetic bone substitutes increased, and the proportion of autografts decreased year by year.
Synthetic bone substitutes were most frequently used for replacement arthroplasty (31%). Fifty percent of banked bone allografts
were performed for joint disorders requiring replacement arthroplasty. During this period, 271 institutions performed banked
bone allografts, with 210 preserving allografts in their own institutions. Donor selection criteria, processing and preservation
methods, and management of the bone bank were not the same in all banks.
Conclusions Most bone grafts performed in Japan during the four surveys were still autografts. However, the proportion of autografts decreased,
and the proportion of synthetic bone substitutes increased. The number of synthetic bone substitutes and banked bone allografts
used for replacement arthroplasty increased significantly. However, the total number of banked bone allografts reported in
the fourth survey was still low. Quality control of banked bone allografts and management of bone banks were not satisfactory,
although they were improved. |
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