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The use of musculoskeletal allografts in knee surgery is expanding as outcome studies continue to delineate roles for ligament, meniscal, and osteochondral allografts.
The use of musculoskeletal allografts in knee surgery is expanding. Allograft tissues are a vital tool of the orthopedic surgeon in the treatment of multiple knee pathologies. Common uses of allografts in the knee include ligament reconstruction, meniscal allografts, and osteochondral allografts. As the science and tissue processing of allografts advances, these tissues become increasingly attractive to the orthopedic surgeon.
A complication of allograft use is the spread of disease and infection from donor to host. However, more groups are becoming involved in ensuring the safe use of musculoskeletal allografts in knee surgery. Founded in 1976, The American Association of Tissue Banks (AATB) frequently updates its Standards for- Tissue Banking manual; it is important that surgeons using allograft tissues become familiar with these guidelines. Orthopedic surgeons should only use allograft tissues from AATB-accredited tissue banks and should be familiar with the processing techniques of the chosen bank. As the safety of allograft tissues in musculoskeletal medicine improves, the indications for their use will continue to expand appropriately.
The US Food and Drug Administration (FDA) and the AATB regulate the quality and safety of allograft tissues. Accreditation by the AATB is voluntary; however, lack of accreditation by the AATB should be a red flag to the orthopedic surgeon. The AATB frequently revises its publication Standards forlissue Banking;Uie llth edition was published in 2006.1
The Musculoskeletal Transplant Foundation2 (MTF) is a not-for-profit organization founded by academic orthopedic surgeons in 1987. This group is dedicated to providing musculoskeletal allografts of the highest quality and safety. The MTF is one of the largest providers of allograft tissue in the world, as in 2002 it recovered 4431 donors and distributed almost 300,000 units of tissue.
In the past 15 years the MTF has had no confirmed allograft associated infection in >2 million units of transplanted tissue. The MTF uses high standards for the screening and selection of donors. These procedures have been validated by the lack of adverse events associated with MTF tissue, and these standards could be used as a template within the industry.2
The Tissue Banking Project Team was established by the American...