Processed versus fresh frozen bone for impaction bone grafting in revision hip arthroplasty

Board TN, Brunskill S, Doree C, Hyde C, Kay PR, Meek RD, Webster R, Galea G

Summary

Processed versus fresh frozen bone for repairing the bone in revision hip surgery

This summary of a Cochrane review presents what we know from research about the advantages and disadvantages of using fresh frozen bone or processed bone for repairing the hip bone during surgery.

The review shows that no studies were found that compared the clinical utilities of  processed versus fresh frozen bone in revision hip surgery.
 

What is revision hip surgery and what are processed and fresh frozen bone?

The most common problem with hip replacements is that the prosthesis used to replace the original diseased bone begins to loosen over time.  This happens because some bone is lost at the hip joint over the years.  This usually happens 10 or more years after having the operation.   Sometimes another surgery, called a “revision surgery” is needed to remodel the lost bone.  During this type of surgery a technique called impaction grafting can be used to replace the lost bone. Impaction grafting involves the pressing of small bone chips into the top of the thigh bone or the cavities either side of the hip bone.    
Two types of bone  can be used: processed or unprocessed (fresh frozen).  The bone comes from donors and is stored and processed in “Tissue Establishments”, similar to the way blood is donated and stored. Bone donations are thoroughly screened prior to use. Processing the donated bone prior to use in impaction grafting limits the rare possibility of transmitting infections e.g. HIV or Hepatitis.  However there is concern that processed bone is less clinically satisfactory than fresh frozen bone.