Introduction The need for bone graft has increased in recent years partly due to the greater numbers of revision hip arthroplasties being performed secondary to the increasing life expectancy in the UK.

Method Our study prospectively reviewed the practice of bone banking at Portsmouth Hospital NHS Trust to look into the various factors responsible for exclusion of patients from donation of bone. All 55 patients under-went screening in a preoperative assessment clinic using a standard proforma to assess their suitability for femoral head donation during the course of their primary hip arthroplasty and records at the bone bank were then reviewed post operatively to check whether bone had been harvested from these individuals during surgery. Results 95% of the patients screened did not proceed to bone banking. After the initial screening stage 33 patients (60%) were excluded due to a variety of reasons. The majority of those excluded (23 patients) were not accepted as donors because of the potential risk of transmission of disease to their recipients.

Although 22 patients (40%) were consented for allograft donation, femoral heads from only 3 patients (5%) were harvested and sent for storage in the bone bank during hip arthroplasty.

Discussion The harvesting of viable bone stock was shown to be poorly utilised in our study. Orthopaedic surgeons must take an active part in bone banking and alternative sources of bone grafts need to be explored in the future to meet the increasing demand.