Bone banking in Denmark, results of a nationwide survey

In a nationwide survey, all orthopaedic clinics were surveyed via a questionnaire about the use of bone allografts and how they managed their bone banks. Thirty-two clinics (100 per cent) responded to the questionnaire (mid 1991). Seventeen clinics had established bone banks on the basis of femoral heads obtained from donors during primary hip replacement. Only five used bone substitutes. The mean consumption was 30 capita per year (10-132) and ten clinics estimated an increasing demand for allografts. The storage method was by freezing at temperatures varying from minus 20 to minus 80 degrees Celsius. Contraindications to procurement comprised history of infection and malignancy, all clinics tested donors for HIV antibodies and all but one for hepatitis B. Testing for hepatitis C was about to be introduced. All but one clinic developed cultures from the procured bone. Informed consent was employed by nearly all clinics, but very few obtained written consent. Since this survey, revised recommendations have been directed from the Danish National Board of Health, these listing that an HIV-test should be performed with a 90-day interval, and that testing should also be done for hepatitis B and C. International experience and this survey show that the establishment of more specific and general national recommendations would be preferable to present practice.