Application of Allograft in Orthopaedic Surgery at Hatyai Hospital - Live Demonstration of two cases

Surgical procedures were carried out at the Hatyai Hospital, Hatyai, Thailand.  Request for the grafts were placed at the Bangkok Biomaterial Center by the Consultant Orthopaedic Surgeon responsible for the cases. After reviewing the X-rays and following the regular protocol of our center, the grafts were dispatched to the hospital one day in advance. The scheduled date for the surgery was 30th of March 1999. The team from our center left for Nakhorn Ratchsima in two batches. The first batch consisting of Prof. Yongyudh Vajaradul - Director of the center, left at at 9.15 pm on 29th March 1999 and the 2nd batch consisting of  Mr. Reyaz Alam Qayami - Research & International relations co-ordinate and  Mr. Sahachart Makdilog - Assistant left the Center at 5.50 Pm on the 29th March 1999 with the allografts.Tthe team from our center went to record the procedure and also at the same time help in moral boosting and confidence building of the surgical team over there. The details of the surgery are mentioned below. Both the cases involved the application of allograft in the femur and pelvic. The first case as indicated below was Osteosarcoma in the shaft of femur of a 13 years old boy. So it was attempted to use the shaft of a whole Humerus. To compensate the bone loss. The 2nd case being a revision total hip arthoplasty with acetabular migration, a head of femur was used to fill in the acetabular defect.   Details of the process are indicated in the particular cases..

Case 1    (Click here for surgical photos)

Patient Name  :     Master. T

Age  :     13 years

Diagnosis :    Osteosarcoma of the Shaft of Femur, pathological fracture at the shaft of femur

Chief complaint :     Pain while walking in the right femur, 

History of complaint :  Pain and swelling in the right femur..

Operative management:     The bone loss was approx 18 cm after resection of the lesion which was substituted  with a deep frozen Allograft                              from the Humerus and stablized with an Intramedullary Interlocking nail Internal Fixation.

Operative time:    3 hrs 20 mins

Operating Surgeon:     Dr.P

Case 2    (Click here for surgical photos)

Patient Name  :     Ms .T

Age  :     58 years

Diagnosis :    Acetabular migration with metalosis and formation of Pseudoacetabulum.. 

Chief complaint :     Extreme pain and immobility of the right hip.

History of complain :     Total hip prosthesis removed due to migration of the acetabular component and loosening of the Femoral stem                          prosthesis..

Operative management:     Removal of all possible metalosis affected tissue, Curretage and filling the acetabular defect with a head of Femur. In this particular case a deep frozen femoral head was taken. The cartilage from the articulating surface was scooped out with a chisel, till the subchondral bone was visible. This head was then pushed inside the acetabular cavity. Reaming was done with an acetabular reamer to make the acetabulam. A cementless Acetabular cup was placed in this new acetabular surface. The cup was supported with a metal back and held with three screws. In the femoral part a cementless Femoral Prosthesis was used..

Operative time:    3 hrs 20 mins

Operating Surgeon:     Dr. P