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Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_III | Pages 256 - 257
1 Mar 2004
Hirn M Laitinen M Aho A
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Aims: The aim of this study was to evaluate the long-term results of osteoarticular allografts operated during the years 1973–1992. Materials: 33 osteoarticular allograft operations were performed because of malignant (14) and benign tumors (19). The mean follow-up time was 15 years. Eight patients were excluded because of death (5) and amputation (3). Results: 25 (76%) of the grafts survived more than 10 years. 18 were whole-joint grafts and 7 hemi-joint grafts. 13 grafts situated in proximal tibia, 11 in distal femur and one in distal tibia. So far three cases have been converted to arthroplasty and two to arthrodesis. 20 grafts are still functioning. 19 of them are excellent or good according to Mankin score. Whole-joint and hemi-joint allografts were clinically equally good. Clear degeneration is seen in every joint and during the time the range of motion tends to decrease because of osteoarthrosis but clinically the patients were surprising painless. Conclusions: The operation is demanding and may cause a large variety of complications, for instance infection, non-union, fatigue fracture, nerve palsy and joint instability. On the other hand, the graft may provide weight-bearing bone that will incorporate biologically into the host skeleton and function almost as a normal joint for years. As prosthesis solutions have also problems and tend to fail with time, osteoarticular allografts should be taken to serious consideration when the first operation method is chosen.


Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_III | Pages 218 - 218
1 Mar 2004
Hirn M
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The growing amount of tissues transplanted every year challenges the bookkeeping of tissue banks to guarantee prompt and reliable traceability. The task is even harder when the tissues are procured, stored and transplanted in diffenrent hospitals. The problems faced us during the years led us to seek a solution from the new electronic possibilities.

The Tampere University Tissue Bank is collecting tissues and data from 9 different units. The tissues have been transplanted mostly in Tampere University Hospital but delivered also to 10 other hospitals for transplantation. A Microsoft Access based program was used for bookkeeping. We had to do double work when bringing the data from papers to tha Access database. To ease the work we started to develop a Web-based program, which could discuss between the different units.

An up-to date Web-based program has been created and it has been testdriven from the beginning of September 2002. The tissue-harvesting and tissue-transplanting units can fill the electronic forms ready in Web. The central bank sees the up-to-date information in the central registry in the Web. For the sake of patient security the forms are planned so that every box in the form has to be filled or otherwise the program does not progress and you are not able to continue. We have managed to minimize the mistakes of tissue bookkeeping caused by human errors. We have also managed to speed-up and standardize the whole bookkeeping process of tissue-harvesting and tissue-transplanting dramatically. It is also very easy to generate different kind of research reports by thisWeb-based system. The security of the data is guaranteed by encrypted connections and fault-tolerant server clusters situated in high-security hosting centres.

We have been able to remove the overlapping paper work. There are no more missing or wrongly filled data. The several paper-vision files of tissue on different stages during the laboratory checking is now replaced only with one final file, which is printed for archive when the tissue has been used and also the data or recipient has been filled. The forms and the whole program are easy to modify and all users can utilize the new up-to-dated versions immediately. It makes the database very flexible and every user has the possibility to improve the program. Because of these improvements the safety and the possibility for quick traceability have been increased.