Bone grafts have been somewhat controversial in recent years. These operations often occur thanks to donated bone pooled from overseas, the source of which can be difficult to trace if something goes awry. You may recall a shocking story in which veteran BBC radio presenter Alistair Cooke’s bones were stolen after he died in the US from cancer (which had spread to his bones), and his bones were thought to have been taken for use in surgery.
However, a new ‘super’ bone graft sourced in the UK is set to change this controversial status quo. Every year at least 26,000 Britons have a bone graft, either to repair a fracture or to fuse bones to prevent pain caused by arthritis or osteoporosis. Usually, this involves forming powdered bone (often sourced from overseas) into a putty which acts as a scaffold, inducing new bone to form and fuse with the old. This provides a strong bond, but a new ‘super’ version, known as demineralised bone, could prove even more effective, and may be manufactured in the UK.
Demineralised bone has been treated to remove minerals and expose the stimulating proteins in the bone, so the graft is even better at encouraging new bone. Up until now, demineralised bone came from overseas because the NHS Blood and Transplant (NHSBT) hasn’t had the resources to produce it in the UK, but now it can thanks to a major investment. The organisation is finally in control of the whole process from donor selection and consent, to tissue retrieval, processing and storage to distribution, and so wellness experts say that the system is much more efficient and safer for patients.
According to consultant spinal surgeon Iona Collins, ‘Using NHS-sourced demineralised bone matrix is a major advance. Most importantly, we know exactly where each vial has come from, since it comes from one UK donor alone.’ The donated bone can come from the donor organ register, families who donate after their loved one’s death or living donors can also donate the top of their thigh bone, which is removed during a hip replacement.
Masood Shafafy, a consultant spinal surgeon at the Queen’s Medical Centre in Nottingham and spokesman for the British Orthopaedic Association, explained, ‘Demineralised bone matrix is widely used in spinal surgery. However, like blood transfusion, it is obtained by donation — the new screening and processing by NHSBT is top notch, and instead of material coming from multiple donors in the States it comes from a single UK donor, who could be traced in case of a problem.’
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