Frozen cancellous bone allografts: positive cultures of implanted grafts in posterior fusions of the spine

Barriga, A.; Díaz-de-Rada, P.; Barroso, J. L.; Alfonso, Matías; Lamata, Marta; Hernáez, Silvia; Beguiristáin, J. L.; San-Julián, Mikel; Villas, Carlos

doi:10.1007/s00586-003-0633-9

Cited by 43 publications

(37 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several studies have suggested that grafts with intraoperative positive cultures do not necessarily progress to clinical infection 6,[25][26][27] . However, those studies did not examine situations with a known contamination event, which may increase the likelihood of a clinically important infection.…”

Section: Discussionmentioning

confidence: 99%

Are Dropped Osteoarticular Bone Fragments Safely Reimplantable in Vivo?

Bruce

Sheibani-Rad

Appleyard

et al. 2011

Journal of Bone and Joint Surgery

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Are Dropped Osteoarticular Bone Fragments Safely Reimplantable in Vivo?

Bruce

Sheibani-Rad

Appleyard

et al. 2011

Journal of Bone and Joint Surgery

View full text Add to dashboard Cite

show abstract

“…[2][3] Although allogeneic bone graft avoids donor-site morbidity, its use is somewhat limited by immune-mediated rejection, potential disease transmission, and decreased osteogenic potential from sterilization procedures. 4 Due to the efficacy and safety concerns associated with the use of bone grafts, a growing number of new treatment modalities have been investigated and utilized clinically. However, these new bone graft substitutes are not without their own challenges.…”

mentioning

confidence: 99%

A Comparative Evaluation of Factors Influencing Osteoinductivity Among Scaffolds Designed for Bone Regeneration

Hsu

Ghodasra

Ashtekar

et al. 2013

Tissue Engineering Part A

View full text Add to dashboard Cite

Due to differing compositions, synthetic scaffolds developed for bone regeneration vary widely in efficacy. To quantify the impact of such differences on osteoinductivity, numerous parameters were examined. Absorbable collagen sponge (ACS), three ceramic-based carriers (#1-3) of varying compositions, mineralized allograft chips, and an experimental phosphoserine-rich nanofiber scaffold [S(P) gel] were compared in their ability to promote cell adhesion, proliferation/survival, growth factor binding/release, and osteogenic gene expression. Human preosteoblasts were found to adhere most efficiently to the S(P) gel, and the growth/survival was greatest on the S(P) and ACS scaffolds, with minimal growth seen on the allograft and Ceramic #3. In bone morphogenetic protein-2 (BMP-2) binding/release assays, ACS demonstrated a burst release pattern, whereas the allograft and the ceramics inefficiently released BMP-2. The S(P) gel showed the most ideal rates of growth factor binding and release. QPCR analyses showed significant differences in the CXCL12, CXCR4, and RANKL transcripts among the cells grown on these various scaffolds. Although some scaffolds showed an advantage over others in individual parameters, the nanofiber gel appears to provide the optimal balance in the factors important to osteoinductivity evaluated here.

show abstract

“…Some centres have instituted a protocol that treats all patients with a positive intraoperative culture with empiric antibiotics. 7 One study found no significant postoperative infections related to positive intraoperative bone allograft cultures when patients with positive cultures were treated with 500 mg of Cefadroxile twice daily for 3 weeks; however, the authors stated there was little evidence for this protocol, and it was not compared with other regimens. 7 Most centres do not have a treatment protocol for patients with positive allograft cultures, and practices range from providing no empiric antibiotic treatment in patients with positive intra operative allograft cultures to providing empiric intra venous antibiotic therapy.…”

Section: Resultsmentioning

confidence: 99%

“…The average positive intraoperative allograft bone culture rate reported in the literature ranges from 1.4% to 12%. 4,7,9,[11][12][13] Although some studies comment that cases of positive cul ture taken at the time of implantation went on to develop wound infections, 2,6 most studies suggest that these posi tive cultures do not correlate with postoperative infections and that the organisms isolated in the postoperative infec tion are only rarely the same as those isolated in the intra operative allograft culture. 9,10,12,14,15 It is difficult to apply these results to all populations, as national policies for handling allograft bone differ.…”

mentioning

confidence: 99%

Intraoperative culture positive allograft bone and subsequent postoperative infections: a retrospective review

Sims

Kulyk

2017

CJS

View full text Add to dashboard Cite

Background: Obtaining intraoperative cultures of allograft bone just before use in ortho pedic procedures is standard practice in many centres; however, the association between positive cultures and subsequent surgical infections is unknown. Our study had 3 goals: to determine the prevalence of positive intraoperative allograft culture and subsequent infec tion; to determine if, in cases of subsequent infection, organisms isolated at reoperation were the same as those cultured from the allograft at the time of the index procedure; and to assess the costs associated with performing intraoperative allograft cultures. Methods:In this retrospective case series, we obtained data on patients receiving allograft bone between 2009 and 2012. Patients receiving allograft with positive cul tures were reviewed to identify cases of significant infection. Organisms isolated at reoperation were compared with the allograft culture taken at the time of implanta tion, and we performed a cost assessment.Results: Of the 996 allograft bone grafts used, 43 (4.3%) had positive intraoperative cultures and significant postoperative infections developed in 2, requiring reoperation. Antibiotics based on culture results were prescribed in 24% of cases. Organisms cul tured at the time of reoperation differed from those isolated initially. The cost of per forming 996 allograft cultures was $169 320. Conclusion:This series suggests that rates of positive intraoperative bone allograft culture are low, and subsequent infection is rare. In cases of postoperative infection, primary allograft culture and secondary tissue cultures isolated different organisms. Costs associated with performing cultures are high. Eliminating initial culture testing could save $42 500 per year in our health region.Contexte : L'obtention de cultures d'allogreffes osseuses peropératoires juste avant une intervention orthopédique est une pratique standard dans de nombreux centres. Or, on ignore s'il y a un lien entre des résultats de cultures positifs et les infections chirurgicales subséquentes. Notre étude avait 3 objectifs : déterminer la prévalence des cultures d'allogreffes peropératoires positives et des infections subséquentes; déterminer si, dans les cas d'infections subséquentes, les agents pathogènes isolés lors d'une réintervention étaient les mêmes que dans les spécimens prélevés sur les allogreffes au moment des interventions initiales; évaluer les coûts associés à l'obtention des cultures d'allogreffes peropératoires.

show abstract

Frozen cancellous bone allografts: positive cultures of implanted grafts in posterior fusions of the spine

Cited by 43 publications

References 10 publications

Are Dropped Osteoarticular Bone Fragments Safely Reimplantable in Vivo?

Are Dropped Osteoarticular Bone Fragments Safely Reimplantable in Vivo?

A Comparative Evaluation of Factors Influencing Osteoinductivity Among Scaffolds Designed for Bone Regeneration

Intraoperative culture positive allograft bone and subsequent postoperative infections: a retrospective review

Contact Info

Product

Resources

About