Abstract
With bone impaction grafting, cancellous bone chips made from allograft femoral heads are impacted in a bone defect, which introduces an additional source of infection. The potential benefit of the use of pre-processed bone chips was investigated by comparing the bacterial contamination of bone chips prepared intraoperatively with the bacterial contamination of pre-processed bone chips at different stages in the surgical procedure. To investigate baseline contamination of the bone grafts, specimens were collected during 88 procedures before actual use or preparation of the bone chips: in 44 procedures intraoperatively prepared chips were used (Group A) and in the other 44 procedures pre-processed bone chips were used (Group B). In 64 of these procedures (32 using locally prepared bone chips and 32 using pre-processed bone chips) specimens were also collected later in the procedure to investigate contamination after use and preparation of the bone chips. In total, 8 procedures had one or more positive specimen(s) (12.5 %). Contamination rates were not significantly different between bone chips prepared at the operating theatre and pre-processed bone chips. In conclusion, there was no difference in bacterial contamination between bone chips prepared from whole femoral heads in the operating room and pre-processed bone chips, and therefore, both types of bone allografts are comparable with respect to risk of infection.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Byrne AM, Morris S, McCarthy T, Quinlan W, O’Byrne JM (2007) Outcome following deep wound contamination in cemented arthroplasty. Int Orthop 31(1):27–31. doi:10.1007/s00264-006-0121-z
Chiu CK, Lau PY, Chan SW, Fong CM, Sun LK (2004) Microbial contamination of femoral head allografts. Hong Kong Med J 10(6):401–405
Clarke MT, Lee PT, Roberts CP, Gray J, Keene GS, Rushton N (2004) Contamination of primary total hip replacements in standard and ultra-clean operating theaters detected by the polymerase chain reaction. Acta Orthop Scand 75(5):544–548. doi:10.1080/00016470410001394
Davis N, Curry A, Gambhir AK, Panigrahi H, Walker CR, Wilkins EG, Worsley MA, Kay PR (1999) Intraoperative bacterial contamination in operations for joint replacement. J Bone Joint Surg Br 81(5):886–889
Gie GA, Linder L, Ling RS, Simon JP, Slooff TJ, Timperley AJ (1993) Impacted cancellous allografts and cement for revision total hip arthroplasty. J Bone Joint Surg Br 75(1):14–21
Gristina AG, Costerton JW (1985) Bacterial adherence to biomaterials and tissue. The significance of its role in clinical sepsis. J Bone Joint Surg Am 67(2):264–273
Ivory JP, Thomas IH (1993) Audit of a bone bank. J Bone Joint Surg Br 75(3):355–357
Knobben BA, Engelsma Y, Neut D, van der Mei HC, Busscher HJ, van Horn JR (2006) Intraoperative contamination influences wound discharge and periprosthetic infection. Clin Orthop Relat Res 452:236–241. doi:10.1097/01.blo.0000229339.11351.ea
Labek G, Thaler M, Janda W, Agreiter M, Stockl B (2011) Revision rates after total joint replacement: cumulative results from worldwide joint register datasets. J Bone Joint Surg Br 93(3):293–297. doi:10.1302/0301-620X.93B3.25467
Maathuis PG, Neut D, Busscher HJ, van der Mei HC, van Horn JR (2005) Perioperative contamination in primary total hip arthroplasty. Clin Orthop Relat Res 433:136–139. doi:00003086-200504000-00021
Mahomed NN, Barrett JA, Katz JN, Phillips CB, Losina E, Lew RA, Guadagnoli E, Harris WH, Poss R, Baron JA (2003) Rates and outcomes of primary and revision total hip replacement in the United States medicare population. J Bone Joint Surg Am 85-A(1):27–32
Ridgeway S, Wilson J, Charlet A, Kafatos G, Pearson A, Coello R (2005) Infection of the surgical site after arthroplasty of the hip. J Bone Joint Surg Br 87(6):844–850. doi:10.1302/0301-620X.87B6.15121
Schreurs BW, Slooff TJ, Buma P, Gardeniers JW, Huiskes R (1998) Acetabular reconstruction with impacted morsellised cancellous bone graft and cement. A 10- to 15-year follow-up of 60 revision arthroplasties. J Bone Joint Surg Br 80(3):391–395
Slooff TJ, Huiskes R, van Horn J, Lemmens AJ (1984) Bone grafting in total hip replacement for acetabular protrusion. Acta Orthop Scand 55(6):593–596
Sommerville SM, Johnson N, Bryce SL, Journeaux SF, Morgan DA (2000) Contamination of banked femoral head allograft: incidence, bacteriology and donor follow up. Aust N Z J Surg 70(7):480–484
van de Pol GJ, Sturm PD, van Loon CJ, Verhagen C, Schreurs BW (2007) Microbiological cultures of allografts of the femoral head just before transplantation. J Bone Joint Surg Br 89(9):1225–1228. doi:10.1302/0301-620X.89B9.18864
van der Donk S, Weernink T, Buma P, Aspenberg P, Slooff TJ, Schreurs BW (2003) Rinsing morselized allografts improves bone and tissue ingrowth. Clin Orthop Relat Res 408:302–310
Vehmeyer SB, Slooff AR, Bloem RM, Petit PL (2002) Bacterial contamination of femoral head allografts from living donors. Acta Orthop Scand 73(2):165–169. doi:10.1080/000164702753671740
Whyte W, Hodgson R, Tinkler J (1982) The importance of airborne bacterial contamination of wounds. J Hosp Infect 3(2):123–135
Zhan C, Kaczmarek R, Loyo-Berrios N, Sangl J, Bright RA (2007) Incidence and short-term outcomes of primary and revision hip replacement in the United States. J Bone Joint Surg Am 89(3):526–533. doi:10.2106/JBJS.F.00952
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Mathijssen, N.M.C., Sturm, P.D., Pilot, P. et al. Comparison of contamination of femoral heads and pre-processed bone chips during hip revision arthroplasty. Cell Tissue Bank 14, 615–620 (2013). https://doi.org/10.1007/s10561-013-9362-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10561-013-9362-4