Name: Fresh Osteochondral Allografts An Introduction for Surgeons
Uploaded: 2020-07-19T00:00:00Z
Channel: Arthrex
Description: Paul Caldwell, MD (Richmond, VA), provides an introduction to the ordering and case scheduling process for fresh osteochondral allografts for surgeons.

<p>Paul Caldwell, MD (Richmond, VA), provides an introduction to the ordering and case scheduling process for fresh osteochondral allografts for surgeons.</p>

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VID1-000850-en-US | A | Fresh Osteochondral Allografts An Introduction for Surgeons

Paul E. Caldwell III

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Fresh Osteochondral Allografts An Introduction for Surgeons

Hi, my name is Paul Caldwell, and I'd like to talk to you about the key steps in ordering a fresh osteochondral allograft that will help ensure a smooth process. The availability of fresh Osteochondral allografts has greatly improved over recent years. Arthrex has facilitated this process by partnering with several tissue providers, as well as supplying the instrumentation and technical expertise for these procedures. Obtaining a fresh osteochondral allograft begins with the generosity of a donor and a donor family. These donors range in age from 12 to 35 years old. The steps you see here highlight the enormous effort from the donor recovery agencies and tissue processing facilities to ensure that surgeons get the best grafts for their patients. In the first three days, the donor must be recovered and processed. In the following days, the donor chart and serologies are completed and the initial culture review begins as early as day eight. The preliminary graph, match and confirmation takes place, with subsequent preliminary draft offers to follow between days 15 and 20. The final culture results are reviewed and the chart is cleared if acceptable. The graph releases and is ready for shipment. It is optimal for graphs to be implanted within 28 days from donor death. Due to the decline in chondrocyte viability, extracellular matrix degradation, and reduced graft function due to the high demand and small donor pool. There is a limited number of osteochondral allografts available for implantation. Patients and surgical facilities should understand that these graphs are treated like an organ donation. This ensures that all involved parties understand the necessity for prompt action and flexibility when it comes to the timing of surgery. Obtaining insurance approval prior to order submission is critical to this process and can be quite time consuming. Assuming most insurance companies require details regarding the chondral lesion size and grade to determine approval eligibility, proper documentation in the operative and clinical notes is imperative to avoid approval delays. For more detailed information about insurance reimbursement, feel free to contact your tissue provider about assessing reimbursement support. Another key preoperative step is the submission of imaging to the tissue provider to obtain the best possible match for your patient. The tissue provider prefers an MRI or CT scan, which may be uploaded via a secure website. Alternatively, an X-ray with a magnification marker placed adjacent to the involved side of the joint may be used. Magnification markers are available upon request from the tissue provider. Once these requirements are met, the most efficient way to request a graft is to use the online order form. Another option would be to fax or email an osteochondral allograft form to the tissue provider. Once a match is found, a formal offer and photo dissection sheet will be sent to the surgeon's office outlining the donor measurements. Upon receipt, the surgeon will review the offer and if approved, will return the signed offer to the tissue provider, preferably via electronic signature, faxing or emailing. The assigned offer is always an option as well. Once final eligibility and testing is cleared, the allograft can be shipped. Be sure to communicate with your Arthrex technology consultant throughout this process, as they will help you acquire the appropriate instrumentation and assist your team during the case. The ifu found inside the box outlines the storage and handling parameters. Remember to never place a fresh osteochondral allograft in the freezer, and any unused tissue should always be discarded, according to the hospital protocol. Over many years, I've learned a few key pearls when requesting an osteochondral allograft. Using the tissue provider's reimbursement tools has helped expedite the necessary insurance approval prior to order submission. Also, being flexible to different graft options has allowed me to receive more offers and a quicker match. For instance, being willing to accept a lateral condyle graft for a medial condyle defect can certainly accelerate the process. This practice has worked well for me and is supported by multiple publications. Educating the office staff, patient and hospital staff regarding the time sensitive nature of this process has allowed our team to respond promptly once a graft offer is received. They understand that flexibility and availability are paramount for this process to work efficiently, and potential surgery on short notice is certainly realistic. For additional information or questions, please reach out to your Arthrex technology consultant or your tissue provider. Thank you.

Fresh Osteochondral Allografts An Introduction for Surgeons

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