The use of musculoskeletal allograft tissue in reconstructive orthopaedic procedures has markedly increased over the last decade. Surgeon knowledge of tissue bank practices in donor consent and screening, infectious disease testing and processing is important when making the decision to use these allograft tissues. The orthopaedic surgeon also has the responsibility to inform the patient about the risks, benefits and alternatives of using allograft tissue. Tissue recalls have occurred but hospitals were unable to identify all recipients or determine final disposition of the recalled tissue. This handout provides viewpoints that support a paradigm change. Imagine a national, real-time web-based system that contains a database for donor and allograft registries with systems built in that enhances widespread communication when an adverse event/reaction occurs. If participation by stakeholders is high, immediate identity of tissue that has been recalled could be realized at the hospital and an allograft not inadvertently used before official notification of recall is sent. Compliance by end users to such a web-based system would eliminate the need for completion and mailing of tissue usage cards (see The Joint Commission, Transplant Safety Chapter at Standard TS.03.02.01, EP 7.)