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at London Bridge Hospital

get stuck into the use of

Biological glues

page

eleven

Vivostat PRF® is an autologous, bio-

absorbable, bio-active, biological glue

that has been used in various surgical

fields, such as cardiac surgery, vascular

surgery, hepatic surgery and plastics.

This means it comes from the patients

themselves, dissolves in the body with

time and contains growth factors that

promote healing.

1

It helps seal vascular

grafts, reduces bleeding and bile

leakage in liver resection surgery, and it

covers open wounds and promotes the

healing of chronic ulcers. 120mls of the

patient’s blood is taken and spun down

in theatre at the beginning of a case,

with a process that takes less than 30

minutes, providing 5mls of biological

glue that is then ready for surgical use.

The Vivostat® ‘Tower’ (for spinning down the

patient’s blood) and the Vivostat® ‘Concorde’

applicator pen.

More recently, Vivostat PRF® is being

used at London Bridge Hospital for a

number of specific indications in knee

surgery.

Mr Ian McDermott, Consultant Knee

Surgeon and Managing Partner

of London Sports Orthopaedics

(sportsortho.co.uk), is one of the

country’s leading knee surgeons in

the fields of meniscal transplantation,

biological knee replacement

(reconstruction) and custom-made knee

replacement surgery. He was already

using fibrin glue to secure some of his

chondrotissue® articular cartilage grafts

for articular cartilage replacement in the

knee and he was also using a fibrin glue

called Tisseel, which is derived from

pooled human plasma. However, Mr

McDermott was introduced to Vivostat

PRF® by Alan Rayner in 2014, and since

then, he has performed over 75 cases

where Vivostat PRF® has been used.

Mr McDermott now uses Vivostat PRF®

for a variety of cases, such as:

Articular cartilage grafting: the

Vivostat® acts as a glue to help secure

cartilage grafts in place on the surface

of a knee joint

2

Meniscal transplants: Vivostat® is used

to help glue the meniscal allograft in

place in the joint when replacing a

missing meniscus

3

Knee replacements: here, Vivostat®

is used slightly differently, being

employed more as a fibrin sealant

to raw bone and soft tissue surfaces,

to reduce bleeding, which reduces

post-operative pain and swelling. This

in turn enhances early post-operative

recovery.

The use of Vivostat PRF® is also of

significant interest in the field of knee

replacement surgery. Here, the team

at London Bridge Hospital is currently

working on protocols for potential

prospective research projects to

evaluate patients’ post-operative pain

levels and speed of recovery after knee

replacement surgery, ‘with vs without’

the use of Vivostat PRF®, with clinical

trials being planned with the Sports

Knee surgeons

biological glues

Mr Ian McDermott

MBBS MS FRCS

(Orth) FFSEM (UK)

Mr Alan Rayner

MSc (Haem) RCVP

ECCP FCCP

Consultant Orthopaedic Surgeon,

Managing Partner of London Sports

Orthopaedics, Honorary Professor

Associate, Brunel University School

of Sport & Education.

www.sportsortho.co.uk

Chief Clinical Perfusion Scientist

London Bridge Hospital

References

1. vivostat.com

2. sportsortho.co.uk/treatment/

chondrotissue-grafts

3. sportsortho.co.uk/treatment/

meniscal-transplantation

Biological glues have been around for a number of years now,

however, technology has been progressing and, since 2009,

Alan Rayner and his team from the Perfusion Department

at London Bridge Hospital, have been using Vivostat PRF®

(Platelet-Rich Fibrin) in theatre for selected surgical cases.

Orthopaedics Research Foundation

(the research arm of London Sports

Orthopaedics) and also within the NHS

at St Bartholomew’s and The Royal

London Hospitals.

Discussions are currently underway

regarding establishing London Bridge

Hospital as the UK’s first ‘Centre of

Excellence for Vivostat®’, so that

surgeons from elsewhere in the UK and

from abroad can come and visit to see

and learn how Vivostat PRF® is used in

specific cases.