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Published on: December 3, 2017
Microbial contamination of femoral head allografts
C K Chiu1, P Y Lau, S W W Chan
1Department of Orthopaedics and Traumatology, United Christian Hospital, 130 Hip Wo Street, Kwun Tong, Hong Kong. chiuck1@yahoo.com.hk
Insights
This study found a low microbial contamination rate in bone allografts at a regional hospital. While bone biopsy cultures are reliable, allograft handling procedures require review to minimize contamination risks.
Area of Science:
- Orthopedic Surgery
- Microbiology
- Transplantation
Background:
- Bone allografts are crucial in orthopedic surgery for reconstruction.
- Ensuring the microbial safety of bone allografts is paramount to prevent post-operative infections.
Purpose of the Study:
- To investigate the incidence of microbial contamination in bone allografts at the United Christian Hospital's bone bank.
- To assess the reliability of bone biopsy cultures in detecting contamination.
- To evaluate the infection rates among recipients of bone allografts.
Main Methods:
- A retrospective study was conducted at a regional hospital in Hong Kong.
- Bone biopsies from 151 femoral head allografts retrieved between 1994 and 2000 were analyzed for microbial contamination.
- Infection rates in 81 recipients of implanted allografts were assessed.
Main Results:
- Of 151 retrieved allografts, 9.3% showed positive cultures and were discarded.
- 4.3% of implanted allografts tested positive for microbial growth, but recipients showed no clinical infection.
- 3.2% of recipients developed wound infections despite negative pre-implantation graft cultures.
Conclusions:
- The bone bank demonstrated a low allograft contamination rate, and recipient infection rates were also low.
- Bone biopsy culture is a reliable method for detecting microbial contamination in bone grafts.
- Findings suggest a need to review allograft handling procedures to further minimize contamination risks.
Objective:
To study the incidence of microbial contamination at the bone bank of the United Christian Hospital. DESIGN. Retrospective study.
Setting:
Regional hospital, Hong Kong.
Patients:
A total of 151 patients (33 men and 118 women) who underwent hip arthroplasty surgery and from whom femoral head allografts were retrieved between January 1994 and March 2000; and 81 patients in whom allografts were implanted.
Main Outcome Measures:
Bone biopsies were taken from the femoral head and used to detect any microbial contamination that might have occurred during removal and after storage. The rates of infection among recipients and donors were also assessed.
Results:
Of the 151 allografts, 94 non-contaminated allografts were implanted by the end of the study. Fourteen (9.3%) heads showed positive culture results after retrieval and were discarded. Four (4.3%) of the 94 stored allografts that were implanted tested positive for microbial growth, but the recipients of these allografts did not develop any clinical infection. Three (3.2%) had wound infections after implantation of the stored allografts although the grafts had previously been tested negative for any microbial contamination.
Conclusion:
Our centre has a low allograft contamination rate. The wound infection rate among recipients was also low. The culture of a bone biopsy sample is a reliable method to detect contamination of bone grafts. However, the contamination rate among stored allografts should prompt orthopaedics departments to review allograft handling procedures, so as to minimise the chance of contamination.
