A cost-effective method for femoral head allograft procurement for spinal arthrodesis: An alternative to commercially available allograft

Desmond A. Brown, Grant W. Mallory, Dominique M. Higgins, Mohammed Abdulaziz, Paul M. Huddleston, Ahmad Nassr, Jeremy L. Fogelson, Michelle J. Clarke

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Study Design: A cost-effective procurement process for harvesting, storing, and using femoral head allografts is described. Abrief review of the literature on the use of these allografts and a discussion of costs are provided. Objective: To describe a cost-effective method for the harvesting, storage, and use of femoral heads from patients undergoing total hip arthroplasty at our institution as a source of allograft bone. Summary of Background Data: Spine fusion surgery uses a large proportion of commercially available bone grafts and bone substitutes. As the number of such surgical procedures performed in the United States continues to rise, these materials are at a historically high level of demand, which is projected to continue. Iliac crest bone autograft has historically been the standard of care, although this may be losing favor due to potential donor site morbidity. Although many substitutes are effective in promoting arthrodesis, their use is limited because of cost. Methods: Femoral heads are harvested under sterile conditions during total hip arthroplasty. The patient is tested per Food and Drug Administration regulations, and the tissue sample is cultured. The tissue is frozen and quarantined for a 6-month minimum pending repeat testing of donors and subsequently released for use. The relative cost-effectiveness of this tissue as a source of allograft bone is discussed. Results: The average femoral head allograft is 54 to 56 mm in diameter and yields 50 cm 3 of bone graft, with an average cost of US $435 for processing of the tissue resulting in a cost of US $8.70 per cm 3 of allograft produced. Average production costs are significantly lower than those for other commonly available commercial bone grafts and substitutes. Conclusion: Femoral head allograft is a cost-effective alternative to commercially available allografts and bone substitutes. The method of procurement, storage, and use described could be adopted by other institutions in an effort to mitigate cost and increase supply.

Original languageEnglish (US)
Pages (from-to)E902-E906
JournalSpine
Volume39
Issue number15
DOIs
StatePublished - 2014

Fingerprint

Arthrodesis
Thigh
Allografts
Costs and Cost Analysis
Bone Substitutes
Bone and Bones
Transplants
Arthroplasty
Hip
Tissue Donors
Drug and Narcotic Control
Autografts
United States Food and Drug Administration
Standard of Care
Cost-Benefit Analysis
Spine
Morbidity

Keywords

  • Arthrodesis
  • Bone bank
  • Bone substitute
  • Femoral head allograft
  • Iliac crest bone graft
  • Lumbar spine surgery
  • Spinal fusion
  • Spinal instrumentation
  • Total hip replacement

ASJC Scopus subject areas

  • Clinical Neurology
  • Orthopedics and Sports Medicine
  • Medicine(all)

Cite this

Brown, D. A., Mallory, G. W., Higgins, D. M., Abdulaziz, M., Huddleston, P. M., Nassr, A., ... Clarke, M. J. (2014). A cost-effective method for femoral head allograft procurement for spinal arthrodesis: An alternative to commercially available allograft. Spine, 39(15), E902-E906. https://doi.org/10.1097/BRS.0000000000000395

A cost-effective method for femoral head allograft procurement for spinal arthrodesis : An alternative to commercially available allograft. / Brown, Desmond A.; Mallory, Grant W.; Higgins, Dominique M.; Abdulaziz, Mohammed; Huddleston, Paul M.; Nassr, Ahmad; Fogelson, Jeremy L.; Clarke, Michelle J.

In: Spine, Vol. 39, No. 15, 2014, p. E902-E906.

Research output: Contribution to journalArticle

Brown, DA, Mallory, GW, Higgins, DM, Abdulaziz, M, Huddleston, PM, Nassr, A, Fogelson, JL & Clarke, MJ 2014, 'A cost-effective method for femoral head allograft procurement for spinal arthrodesis: An alternative to commercially available allograft', Spine, vol. 39, no. 15, pp. E902-E906. https://doi.org/10.1097/BRS.0000000000000395
Brown, Desmond A. ; Mallory, Grant W. ; Higgins, Dominique M. ; Abdulaziz, Mohammed ; Huddleston, Paul M. ; Nassr, Ahmad ; Fogelson, Jeremy L. ; Clarke, Michelle J. / A cost-effective method for femoral head allograft procurement for spinal arthrodesis : An alternative to commercially available allograft. In: Spine. 2014 ; Vol. 39, No. 15. pp. E902-E906.
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abstract = "Study Design: A cost-effective procurement process for harvesting, storing, and using femoral head allografts is described. Abrief review of the literature on the use of these allografts and a discussion of costs are provided. Objective: To describe a cost-effective method for the harvesting, storage, and use of femoral heads from patients undergoing total hip arthroplasty at our institution as a source of allograft bone. Summary of Background Data: Spine fusion surgery uses a large proportion of commercially available bone grafts and bone substitutes. As the number of such surgical procedures performed in the United States continues to rise, these materials are at a historically high level of demand, which is projected to continue. Iliac crest bone autograft has historically been the standard of care, although this may be losing favor due to potential donor site morbidity. Although many substitutes are effective in promoting arthrodesis, their use is limited because of cost. Methods: Femoral heads are harvested under sterile conditions during total hip arthroplasty. The patient is tested per Food and Drug Administration regulations, and the tissue sample is cultured. The tissue is frozen and quarantined for a 6-month minimum pending repeat testing of donors and subsequently released for use. The relative cost-effectiveness of this tissue as a source of allograft bone is discussed. Results: The average femoral head allograft is 54 to 56 mm in diameter and yields 50 cm 3 of bone graft, with an average cost of US $435 for processing of the tissue resulting in a cost of US $8.70 per cm 3 of allograft produced. Average production costs are significantly lower than those for other commonly available commercial bone grafts and substitutes. Conclusion: Femoral head allograft is a cost-effective alternative to commercially available allografts and bone substitutes. The method of procurement, storage, and use described could be adopted by other institutions in an effort to mitigate cost and increase supply.",
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AU - Abdulaziz, Mohammed

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AU - Nassr, Ahmad

AU - Fogelson, Jeremy L.

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KW - Spinal instrumentation

KW - Total hip replacement

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