ABSTRACT
Bone allografts have been used primarily for limb salvage procedures in orthopedic oncology. Tissue banks have made bone readily available, and this availability arose from the interest of surgeons treating more current bone loss such as that associated with implant loosening. Bone allografts became part of the reconstruction, and the need for banked bone has sharply risen with the spiraling increase in revision arthroplasty. In Belgium, a country of 10 million inhabitants, 15,000 primary hip and 10,000 knee arthroplasties are performed each year. With patients living longer and a11hroplasty being performed in younger patients, revision arthropLasty for loose hip and knee prostheses has become a major part of current orthopedic practice. In Belgium, hip revision arthroplasties accounted for 12% of primary hip replacements in 2001. Most of these revisions are caused by wear particles that generate an unopposed osteolysis around the implant with progressive implant loosening. Restoration of a bone stock with a conventional implant is a standard approach to dealing with loose cemented implants. In the past, massive allografts were used [L ,2], but these have been repLaced by morseJized impacted bone to reconstruct a stable joint. This chapter describes the CUlTent procedures used to select tissue donors, process bone, and preserve the grafting material.
