title: Mechanical agitation and serial dilution: an option for anterior cruciate ligament graft sterilization.
abstract: Contamination of tissue grafts can occur during anterior cruciate ligament reconstruction, necessitating decontamination. This study examined whether mechanical agitation and serial dilution provides greater bacterial eradication of experimentally contaminated bone-patellar tendon-bone grafts compared with antibiotic soak or pulsatile lavage. Forty bone-patellar tendon-bone grafts were contaminated with a bacterial suspension derived from operating room floor cultures. Four groups of specimens underwent immediate culture (control), antibiotic soak, pulsatile lavage, or mechanical agitation and serial dilution. The number of colony-forming units (CFU) for each group was statistically compared using t and chi-square tests. Each method of decontamination yielded a statistically significant reduction in CFU compared with the control. Analysis of positive versus negative cultures demonstrated a statistically significant difference between mechanical agitation and serial dilution compared with the other 2 methods. Mechanical agitation and serial dilution was the only method with 0 CFU and provided superior and consistent sterilization of experimentally contaminated grafts compared with antibiotic soak and pulsatile lavage.
authors.affiliation: Department of Orthopedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Parker
authors.forename: Steven D
authors.initials: SD
authors.lastname: Maschke
mesh_terms: D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D050376:Bone-Patellar Tendon-Bone Grafting; D003666:Decontamination / Q000379:methods*; D006801:Humans; D009873:Operating Rooms; D013242:Sterilization / Q000379:methods*; D007507:Therapeutic Irrigation; D020858:Tissue and Organ Harvesting; D019737:Transplants / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents