NNUH bone bank

The Norfolk and Norwich University Hospital has taken action to introduce fail-safe measures to its bone bank following an electrical failure on freezers used to store donated bone for grafts in hip replacements.

On January 24 2003, an electrical failure led to a rise in temperature in two freezers used to store bone for orthopaedic operations (hip bone grafts) at the Norfolk and Norwich University Hospital and, whilst the bone remained frozen, a decision has been made not to use the stock.

To meet the needs of patients the hospital is are sourcing bone to the required high standards from outside the trust and all steps have been taken to ensure patients are not disadvantaged.

A small number of patients have self-donated bone from previous hip operations with a view to later using bone for further operations. If they need an operation they will still get bone needed for their procedure. The rest of the donations have been made by patients undergoing a hip replacement for the use by others needing bone grafts.

The hospital has written to patients who have donated bone and is very grateful to those donor patients and regrets the unfortunate loss of donated bone stock. The letter to patients outlines what has happened and what measures we are taking to ensure such a failure does not happen again

Mr John Nolan, consultant orthopaedic surgeon, said: “There is no way that we will take any chances whatsoever with the bone that was in the freezers at the time the fault occurred. Even though we think it is unlikely that the bone could have become contaminated, we will not accept any increased risk to patients. It is unfortunate that we are unable to use the all the bone we have collected, but we will start again just as soon as the new measures are in place.”

Mr Nolan added: “This has actually given us an opportunity to improve the levels of equipment in the Bone Bank to the very highest standards. Not only should this prevent a recurrence of the failure but it will help to ensure we have strengthened our service and later in the year the Bone Bank will be inspected to rigorous standards which are required for accreditation by the Medicines Control Agency.”

Work is already underway to ensure the freezers are connected to a monitoring system that will ensure they are monitored round-the-clock.

Notes to editors

The use of bone grafts to rebuild lost bone stock around loose hip replacements has revolutionised this most challenging of reconstructive operations.

Bone donated by patients undergoing first-time hip replacements (the femoral head) would normally be discarded, but in Norwich, as in a number of other leading units up and down the country, after consent has been given by the patient, it is kept, deeply frozen in the Bone Bank whilst the results of screening blood tests are awaited, before it is released for use.

It is then thawed, and under very carefully controlled conditions, “milled” into small crouton-size pieces before being impacted into the greatly thinned bones sometimes encountered around loose hip replacements. This enables second or sometimes even third hip replacement operations to be carried out very successfully. Remarkably, the bone acquires a new blood supply and is transformed into the recipient's own bone.

Wednesday 12th of March 2003 03:00:06 PM