Ordering allograft by weight: suggestions for the efficient use of frozen bone-graft for impaction grafting

Impaction grafting of morcellized allograft gives good early results in revision arthroplasty in which there is aseptic endosteolysis. Most surgeons employing this technique use fresh frozen allograft from femoral heads harvested at primary arthroplasty and order bone from the tissue bank in terms of numbers of femoral heads. This article demonstrates that this approach results in great variability in the quantity of graft available for impaction because of the variability in size and density of femoral heads. This variability may compromise the stability of the impacted graft. Surgeons in Raigmore Hospital request allograft by weight not quantity, which predicts more accurately the volume of graft after impaction. Having reviewed the figures to date, we suggest the amount of graft that should be available for certain procedures.