The Centers for Disease Control and Prevention have recently identified five patients in whom bacterial infections were transmitted with musculoskeletal allografts used for the treatment of an isolated osteochondral defect and anterior cruciate ligament (ACL) replacements. Allegations regarding additional cases have been made at various professional meetings, but to date, no additional cases have been described. One of the infections (Clostridium sordellii) resulted in fatality. In other cases, septic arthritis caused by a plethora of microorganisms was treated successfully. Over 700,000 musculoskeletal transplants are now performed annually. Historically, there have been only a few infections associated with these procedures. Incidents described during the past year appear to be avoidable by diligent application of microbiologic monitoring during all phases of allograft excision and preparation. To assure patient safety, orthopaedic surgeons who use musculoskeletal allografts, as well as the tissue banking specialists who supply the same, must insist on comprehensive microbiologic monitoring of tissue donors and of allografts themselves.
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