Microbiological Culture Findings of the Femoral Heads as a Prognostic Factor in the Total Hip Replacement Surgery

BACKGROUND: In primary total hip replacements (THRs), the dissected femoral heads (FHs) are commonly used to make the bone-chips for the reconstruction in the orthopaedic surgery. The donated FHs are routinely microbiologically cultured to identify and contaminated FHs are discarded. This study examines whether a positive FH culture predicts an infection and prosthetic failure after primary THR. METHODS: The study sampled 274 donated FHs from patients with osteonecrosis (ON), hip joint osteoarthritis (OA), and femoral neck fracture (FNF) in THR to culture the microbes. The FH contamination rates were analyzed for ON, OA, and FNF groups. Proportion of the postoperative infection or prosthetic failure in the group of donors with a positive FH culture were compared to the proportion in the group of donors with a negative FH culture. RESULTS: The rates of the positive culture in the ON, OA, and FNF groups were 7.1%, 3.8%, and 4.0%, respectively. The infection rate was found to be non-significantly greater in the ON group than in the OA and FNF groups. In the negative culture group, one patient (0.63%) had a postoperative superficial infection, and five patients (3.2%) experienced additional surgeries including a fixation for a periprosthetic fracture, within a minimum follow-up of two years. However, no postoperative infection was encountered, and no revision surgery was required in the positive culture group. CONCLUSIONS: A positive FH culture is not always associated with elevated risks of infection or prosthetic failure after THR. Therefore, such finding cannot be used as a prognostic factor of THR. The FHs that return a positive culture may not lead to the orthopaedic assessment of an infection or other postoperative complication risks in primary THR.

Producción de un tejido óseo para injerto procesado, esterilizado por radiación / Production of bone tissue for processed bone graft, sterilized by radiation

Los aloinjertos óseos en Cirugía Traumatológica y Ortopédica son cada vez más empleados en procedimientos que logran mejorar la calidad de vida de los pacientes. El Banco de Huesos del Hospital Alemán, habilitado por el I.N.C.U.C.A.I desde octubre de 2003, sigue normas de trabajo y calidad, nacionales e internacionales. Enel presente análisis se describe la forma de proceder en nuestro Banco para la localización del potencial donante, su selección, la procuración de una determinada pieza (cabeza femoral), el procesamiento de la misma, los controles anatomopatológicos, microbiológicos y el método de esterilización y almacenamiento