Femoral head bone allografts have traditionally been used to provide mechanical stability to areas of bony deficiency, or for its osteoinductive and osteoconductive properties. Concerns have been raised over increased infection rates following the use of fresh-frozen graft tissue. This retrospective study aims to investigate the outcomes of fresh frozen femoral heads kept in a regulated, non-commercial bone bank at a university teaching hospital.The local bone bank database was used to identify released femoral heads during a 14 year study period (September 1999-December 2013) whereby a retrospective review of patient records was undertaken to determine clinical outcome. During the observed study period, 427 femoral heads were released from cold storage. Of these, 270 femoral heads had a mean follow-up of 347 days. 157 femoral heads were excluded due to insufficient follow-up data (n = 132) or discarded due to breaks in the cold chain prior to use (n = 25). Of the 270 included femoral heads, 231 (85.6 %) had no reported complications with good graft incorporation. In the remaining 39 with reported complications, only 5 (2.6 %) developed a postoperative infection. Our findings suggest that the use of fresh frozen allograft does not materially increase the risk of post-operative bacterial infection. Our reported post-operative infection rates are comparable with infection rates of other similar studies on fresh frozen allograft use.

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Purpose:To investigate the outcomes of UKR in over 75-year olds in terms of peri-operative morbidity; length of hospital stay and patient reported outcomes (Oxford knee score). Method:A six-year retrospective study of Unilateral Knee Replacements (UKRs) operated on by an experienced consultant orthopaedic surgeon assessed with serial Oxford Knee Scores. The patient selection criteria was based on age, over 75 years old. Secondary outcomes recorded included the length of stay and postoperative complications. Results: Eighteen UKRs were implanted into 16 patients with 2 receiving bilateral UKRs. The mean age at the time of surgery was 77.6 (range 75-87 years). No intra-operative complications or major immediate post-operative complication was observed. No patients required a post-operative blood transfusion and the average length of hospital stay was 4.6 days (+/-1.34). At the 1-year post-operative follow-up the Oxford Knee Score was 34.7 (+/-8.3) increasing to a maximum score of 38.8(+/-4.4) at 4 years postoperative follow-up. During the 5th and 6th postoperative year, the Oxford Knee Score started to decline slightly at 33.5 (+/-6.4) and 32 (+/-11.3) respectively. No patients received revision surgery.Significance: The scores from this study are comparable to that of a total knee replacement in a similar age group. As such UKRs can be a viable alternative to a total knee arthroplasty in an elderly population with multiple comorbidities who may benefit from a less invasive procedure.

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