How a Norfolk hospital's bone bank is helping patients

Dan GrimmerPatients in Norfolk are benefiting from more complex hip surgery than ever before. But, as Sarah Hall reports, this would not be possible without the donation of bone by patients who have had hip replacements.Dan Grimmer

Each year at least 500 patients undergo routine hip replacements at the Norfolk and Norwich University Hospital and about 120 receive bone donated from other patients.

Thanks to a licence to operate a human bone bank at the N&N, it means bone which would usually be discarded during these operations can be used to help people who need more complex hip reconstruction.

Janet Holtaway has run the bone bank for the past 11 years and is responsible for going through a patient's notes before they have a hip replacement to see if they are eligible to give bone, and the bank is supervised by orthopaedic surgeon John Nolan.

If patients did not agree to donate bone, some of the procedures which are carried out would not be possible.

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Ms Holtaway said: "Having a human bone donated for an operation can make a big difference for patients who need hip surgery and it is great that people agree to give their discarded bone.

"I review patients' notes to see if they can donate and, unfortunately, some of them can't because they may have had previous health problems. If someone has had cancer, we cannot risk using their bone in case there is a cancer cell in there; if they have had tuberculosis, they also cannot donate as this disease has been known to spread to the bone.

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"It is a very complex issue but fantastic that we are licensed to run this bank here because it really does mean better lives for some patients."

The bone bank has been running at the N&N for more than 20 years but it has recently won a licence to operate following a rigorous inspection by the Human Tissue Authority.

Stricter guidelines are now in place to ensure donated bone is properly stored and completely safe for patients and there are regulations covering consent too.

Not all hospitals across the UK are fortunate enough to have a bone bank. The N&N has the only one in Norfolk and is one of only three or four in East Anglia. The nearest other bone bank is at Addenbrooke's Hospital in Cambridge.

Many patients have a simple hip replacement - which involves the thigh bone being replaced by a metal ball and pin - and do not need donated bone. But others have complications or severe bone deterioration and need more complex surgery.

Paul Stern, 43, from Cromer Road, Norwich, said his life would not have been the same if he hadn't been given donated bone for his third hip replacement last year at the N&N.

The hydrographic surveyor developed Perthes' disease, a fairly rare condition where the top of the thigh bone (the femoral head) softens and breaks down, at the age of five.

He had this first hip replacement when he was 16 but had to have another after a fall. This lasted 10 years but two years ago he had to have another.

Mr Stern, who is married to Carol, 33, moved to Norwich a few years ago from London and he had heard about the work of Mr Nolan and the bone bank.

Mr Nolan reviewed his hip replacement and found that it was loose and the thickness of bone was very poor due to the hip replacement grinding the bone away and suggested using the bone bank to rebuild his leg.

He said: "With this condition, if it is not treated, you become immobile and I am a fairly active person, so a hip replacement was the only way forward.

"I received nine femoral heads [thigh bones] which means my operation was the result of nine people donating bone. I am extremely grateful to these people as I lead a normal life now.

"I was only in hospital for nine days, recovered really quickly and have been told my new hip should last 20 to 30 years, which is fantastic.

"The results of my hip replacement, and in particular the involvement of the bone bank, has given me a second chance at life.

"I cannot sing the praises of the bone bank loud enough, but it could not exist without people becoming donors and families making brave decisions during their worst moments."

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