Screening femoral heads from living donors: a prospective study comparing swab-agar versus bone fragment-broth culture.

Femoral heads are an important source of allograft bone used in reconstructive orthopaedic surgery. The sterility of donor material is of major importance for the recipient. Femoral heads intraoperatively retrieved during hip arthroplasty from medically screened living donors are routinely checked with a surface swab to exclude microbiological contamination. There is, however, evidence that swab cultures have limited sensitivity. We therefore prospectively compared two ways of screening femoral heads. Bacterial recovery from swabs in Amies transport medium taken intraoperatively, subsequently transported to the microbiology laboratory and inoculated on agar and in broth was compared with the recovery from a bone fragment also taken intraoperatively but immediately inoculated into Wilkins Chalgren broth. Forty femoral heads were tested with both methods. Bacteria were cultured neither from the femoral surface swabs nor from the femoral fragments. Consequently no distinct conclusions regarding the sensitivity of both techniques could be drawn. In addition the bacterial yield of two swabs in Amies transport medium streaked on a variety of culture media other than the conventional agar plates was also studied. Culturing of these swabs resulted in the detection of bacteria that are predominantly considered contaminants.