Fresh-frozen allograft bone is frequently used in orthopaedic surgery. We investigated the incidence of allograft-related infection and analysed the outcomes of recipients of bacterial culture-positive allografts from our single-institute bone bank during bone transplantation. The fresh-frozen allografts were harvested in a strict sterile environment during total joint arthroplasty surgery and immediately stored in a freezer at -78º to -68º C after packing. Between January 2007 and December 2012, 2024 patients received 2083 allografts with a minimum of 12 months of follow-up. The overall allograft-associated infection rate was 1.2% (24/2024). Swab cultures of 2083 allografts taken before implantation revealed 21 (1.0%) positive findings. The 21 recipients were given various antibiotics at the individual orthopaedic surgeon’s discretion. At the latest follow-up, none of these 21 recipients displayed clinical signs of infection following treatment. Based on these findings, we conclude that an incidental positive culture finding for allografts does not correlate with subsequent surgical site infection. Additional prolonged post-operative antibiotic therapy may not be necessary for recipients of fresh-frozen bone allograft with positive culture findings.

Cite this article: Bone Joint J 2015;97-B:427–31.

Backgroud:

Periarticular multimodal drug injection (PMDI) during total knee arthroplasty (TKA) has been reported with promising effects, but some results still remain controversial. Therefore, we conducted a systematic review and meta-analysis based on randomized controlled trials (RCTs) to evaluate the efficiency and safety of PMDI technique in TKA.

In Northern China, Ca intake and serum vitamin-D level of adolescents are low due to non-dairy-based diets and insufficient sunshine exposure. Maximisation of bone mineral accretion in childhood and adolescence requires adequate dietary calcium (Ca) intake and body vitamin-D status. This study focused on nutritional adaptation in Chinese adolescents under these adversed conditions by determining Ca absorption (CaAbn) and urinary calcium excretion (CaEx).

16 healthy individuals (12 girls, 4 boys) aged 9–17-y were recruited from Beijing during December. CaAbn was determined by a dual stable-isotope technique (44Ca and 42Ca) coupled with a Thermal-Ionization -Mass-Spectrometer.

Mean ± sd Ca intake, 24-h CaEx, and serum 25-(OH) vitamin D3 were 603 ±158 mg/d, 87.5 ± 59.2 mg/24-h and 13.7 ± 4.8 ng/mL respectively. Mean serum 25-(OH) vitamin D3 reached the lower normal-limit of 11 ng/mL. 24-h-CaEx (< 100 mg/d) reflected a higher efficiency of Ca retention. CaAbn was found 57.4 ± 15.4% which was significantly higher than the U.S. counterparts (25–34%; Ca intake: 925 mg/d), P< 0.05. However, CaAbn in the current study was comparable to a group of healthy Hong Kong children aged 7-y (CaAbn: 54.8%, Ca intake: 862 mg/d, serum 25-(OH) vitamin D3:33.3 ng/mL).

The study showed that growing individuals with suboptimal vitamin D status are still capable of enhancing calcium absorption and reducing urinary calcium excretion to allow adequate bone Ca accretion.