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Journal of Bone and Joint Surgery - British Volume, Vol 89-B, Issue 9, 1225-1228.
doi: 10.1302/0301-620X.89B9.18864  
Copyright © 2007 by British Editorial Society of Bone and Joint Surgery
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Microbiological cultures of allografts of the femoral head just before transplantation

G. J. van de Pol, MD, Orthopaedic Surgery Resident1; P. D. J. Sturm, MD, PhD, Microbiologist1; C. J. van Loon, MD, PhD, Orthopaedic Surgeon2; C. Verhagen, Director of the Bone Bank3; and B. W. Schreurs, MD, PhD, Orthopaedic Surgeon1

1 Radboud University Nijmegen, Medical Centre, Postbox 9101, 6500 HB Nijmegen, The Netherlands.
2 Rijnstate Hospital, Postbox 9555, 6800 TA Arnhem, The Netherlands.
3 Bone Bank of Sanquin Bloodbank Region South East, Postbox 1013, 6501 BA Nijmegen, The Netherlands.

Correspondence should be sent to Dr B. W. Schreurs; e-mail: b.schreurs{at}orthop.umcn.nl

Allografts of bone from the femoral head are often used in orthopaedic procedures. Although the donated heads are thoroughly tested microscopically before release by the bone bank, some surgeons take additional cultures in the operating theatre before implantation. There is no consensus about the need to take these cultures. We retrospectively assessed the clinical significance of the implantation of positive-cultured bone allografts. The contamination rate at retrieval of the allografts was 6.4% in our bone bank. Intra-operative cultures were taken from 426 femoral head allografts before implantation; 48 (11.3%) had a positive culture. The most frequently encountered micro-organism was coagulase-negative staphylococcus. Deep infection occurred in two of the 48 patients (4.2%). In only one was it likely that the same micro-organism caused the contamination and the subsequent infection.

In our study, the rate of infection in patients receiving positive-cultured allografts at implantation was not higher than the overall rate of infection in allograft surgery suggesting that the positive cultures at implantation probably represent contamination and that the taking of additional cultures is not useful.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General