Microbial contamination of femoral head allografts

CK Chiu, PY Lau, SWW Chan, CM Fong, LK Sun
Department of Orthopaedics and Traumatology, United Christian Hospital, 130 Hip Wo Street, Kwun Tong, Hong Kong

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.

Hong Kong Med J 2004;10:401-5

Key words: Bone banks; Bone transplantation; Femur head; Freezing