Name: Paul Caldwell, MD – Fresh Osteochondral Allografts: Custom Grafts
Uploaded: 2020-07-19T00:00:00Z
Channel: Arthrex
Description: Paul Caldwell, MD (Richmond, VA), provides an introduction to custom allografts and the additional steps required to coordinate recovery of these grafts compared to more commonly available allograft options.

<p>Paul Caldwell, MD (Richmond, VA), provides an introduction to custom allografts and the additional steps required to coordinate recovery of these grafts compared to more commonly available allograft options.</p>

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VID1-000851-en-US | A | Paul Caldwell, MD – Fresh Osteochondral Allografts: Custom Grafts

Paul E. Caldwell III

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Paul Caldwell, MD – Fresh Osteochondral Allografts: Custom Grafts

Hi, my name is Paul Caldwell, and I'd like to talk to you about how to successfully order a custom osteochondral allograft. A custom allograft is harvested and prepared for a specific patient, as opposed to most allografts that are harvested from many possible patients. Examples of a custom allograft may include metatarsals, metacarpals, as well as the distal humerus. Understanding the difference in ordering a custom osteochondral allograft from a standard osteochondral allograft is very important, and I hope to answer any questions you may have. As with all Osteochondral allografts, it should be emphasized that insurance approval must be obtained before requesting a custom graft. Since the custom graft is patient specific, it's important to note that the recovered tissue is unique to that particular patient. So if the graft is requested but then it's not accepted by the surgeon or utilized before expiration, the tissue that could have potentially been donated to an alternate patient is lost. As expected, these grafts take longer to obtain, so alternate options may be offered to accommodate both the surgeon and the patient. For example, consider using a fresh osteochondral allograft precut core when treating a metacarpal or capitular defect, rather than requesting a specific matching allograft, since custom grafts require specific consent from the deceased donor's family. The tissue provider may request additional details from the surgeon to aid in obtaining consent. An example of this would be that the patient is a young female gymnast with a repetitive, high impact injury of the elbow, with dreams of returning to competition. This level of detail helps convey the critical necessity of the graft. When the recovery agency is speaking with the donor family about consent. It is essential that the surgeon's office and patient understand the importance of being flexible and available for surgery on short notice, since the tissue provider has fewer opportunities to recover custom grafts. In these instances, the tissue provider will also work closely with the surgeon's surgeons team to provide updates and give as much notice as possible. The communication between the surgeon, patient and tissue provider is at a much higher level than with traditional allografts. It is recommended that if the surgeon knows a potential conflicts where either the surgeon or the patient may be unavailable for two weeks or more, this information is conveyed to the tissue provider to plan appropriately. In summary, here are some of the pearls about custom graphs that I have learned over the years. Always obtain insurance approval prior to requesting a custom graph. Given these graphs are patient specific, it's imperative that the surgeon's office and patient are ready for surgery on short notice. Also, the surgeon needs to notify the tissue provider of any potential time conflicts, even if they're six months in the future. If you have any questions on the custom allograft ordering process, please contact your Arthrex technology consultant or your tissue provider. Thank you.

Paul Caldwell, MD – Fresh Osteochondral Allografts: Custom Grafts

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