الفهرس 
Introduction
Procurenent proceduresOnly 14 pages are availabe for public view
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Abstract
SUMMARY
The use of foreign bone as grafting material
obviously has greater convenience both for the surgeon
and for the patient. Here is a brief summary of the
whole work classified into paragraphs according to the
chapters of the essay.
Terms associated with osteochondral transplantation
have been defined for preventing either confusion
or disagreement. This was resolved by defining the
intended meanings.
Reconstructive bone surgery is an ancient art. Even
in the time of Hippocrates surgeons were attempting to
use animal tissues as transplant material, but
obstacles and difficulties were enormous. More recent
efforts were attacked on religious grounds and doctor’s
live were threatened by fanatical priests.
It should be borne in mind that a bone bank is
different from a blood bank, as in blood transfusions
there is no regenerative powers attendant whereas in
bone transplants the host must do more than just tolerate
the alien tissue.
The characteristics of allograft bony union to the
host, limited remodeling, and modest periosteal new
bone with soft tissue attachments suggest that allograft
is conditionally accepted by the host.
The selection and proper application of bone
allografts are all based on the biodynamic sequence
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that occurs from the time of transplantation to
incorporation and secondary remodeling.
Fresh allografts showed antigenicity which was as
strong as spleen cell grafts in relation to humeral
and cellular response. The antigenicity of bone is
believed to decrease or disappear as a result of the
destruction of cellular membrane by different methods
of sterilization and preservation.
The establishment of a safe bone banks requires
strict criteria for donor selection. Bone allograft
donors are of two kinds; living donors and cadaver
donors.
Contamination control is the most crucial aspect
of procurement. The type of reconstructive surgery to
be performed will determine how the bones are
obtained.
Many methods have been used for sterilization and
preservation of bone in an attempt to provide safe and
efficacious tissue and to reduce the immunogenicity of
the graft.
It is important to keep accurate records of donor
medical histories and the results of tests used to
confirm sterility and the abscence of transmissible
disease. It is also recommended that random cultures
be obtained periodically to assure maintenance of
sterility.
Retrieval of specific bone is simplest when there
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is a planned organization of bones in the storage
units.
Permission for procurement and storage of bone
should be sought from donors or their next-of-skin.
Although the Uniform Anatomical Gift Act states that,
prior to death, through such measures as a will or a
donor card, removal of tissue is legally protected.
Almost all tissue banks relyon permission from relatives
postmortem before acquiring tissues or organs.
A physician should be ultimately responsible for
activities of a bone bank. Administration of the
financial aspects and the record keeping. However, may
be the responsibility of a non-medical person.
The existing tissue banks vary in their complexity
and scope of operation. Some serve a large number of
surgeons and institutions over a wide geographic area,
while others provide allografts only to surgeons in
their own institutions.
Both cost effectiveness and safety can be realized
in the operation of a community bone bank by adoption
of the following measures: allogenic bone is collected
from femoral heads excised from total hip arthroplasties;
careful donor and graft selection controls
ensure an allograft free of disease which can be
transmitted to the recipient and preservasion by deep
freezing , rather than freeze drying •
The use of osseous and osteochondral allografts
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for the replacement of damaged or diseased bone has
become commonplace. The nature and scope of these
surgical applications include the treatment of cystic
defects, non unions, and arthrodesis as well as major
roles in limb-sparing tumor resections, total joint
reconstruction and spinal surgery.
The complications of allograft transplantation
arise in connection with technical errors, wound
infection and incompatibility between donor and
recipient. The strict adherence to the correct technique
significantly reduces the complications. Infection
and incompatibility can be overcomed with the
suitable methods of sterilization and preservation,
and proper quality control and record keeping.
The experimental findings suggested that, xenograft
bone might be a good bone bank material provided
it was deproteinised and either impregnated with living
autologous red marrow as a composite graft or
placed in a bed of bleeding cancellous bone.
Finally, although bone banking has become a
well-established procedure, investigational studies
are continuing to improve tissue preservation, sizing,
and matching of grafts.