Evidence map›Paper›PMID 40787434›Full record

ReviewJournal of orthopaedics2025

Can contaminated musculoskeletal autografts and allografts Be safely and effectively used in Patients? A systematic review.

Patrick Ryan, Bryce W Rigden, Clayton W Nuelle, James P Stannard, Steven F DeFroda, James L Cook

Abstract readReview
In one paragraph

Review in Journal of orthopaedics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Patrick RyanMizzou Joint Preservation Center, Missouri Orthopedic Institute, Department of Orthopaedic Surgery, University of Missouri, 1100 Virginia Ave, Columbia, MO, 65203, USA.
Bryce W RigdenCreighton University School of Medicine, 2500 California Plaza, Omaha, NE, 68178, USA.
Clayton W NuelleMizzou Joint Preservation Center, Missouri Orthopedic Institute, Department of Orthopaedic Surgery, University of Missouri, 1100 Virginia Ave, Columbia, MO, 65203, USA.
James P StannardMizzou Joint Preservation Center, Missouri Orthopedic Institute, Department of Orthopaedic Surgery, University of Missouri, 1100 Virginia Ave, Columbia, MO, 65203, USA.
Steven F DeFrodaMizzou Joint Preservation Center, Missouri Orthopedic Institute, Department of Orthopaedic Surgery, University of Missouri, 1100 Virginia Ave, Columbia, MO, 65203, USA.
James L CookMizzou Joint Preservation Center, Missouri Orthopedic Institute, Department of Orthopaedic Surgery, University of Missouri, 1100 Virginia Ave, Columbia, MO, 65203, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Musculoskeletal autografts and allografts are used frequently in orthopaedics, and contamination of the grafts can occur. When intraoperative contamination is recognized, the graft can be salvaged for use and postoperative complications minimized with effective decontamination. The purpose of this systematic review was to critically evaluate safety and efficacy of decontamination protocols for tendon, meniscus, and osteochondral grafts in order to provide evidence-based guidelines for graft salvage. Methods: Using PRISMA guidelines, a literature search was performed to identify eligible studies for systematic review of tendon-ligament, osteochondral, and meniscal graft decontamination protocols. Separate searches for tendon, for ligament (tendon-ligament), osteochondral, and meniscal protocols were performed using keywords: (1) "operative", (2) "dropped OR contamination OR sterilization", and (3a) "tendon" or (3b) "ligament" or (3c) "osteochondral" or (3d) "meniscus". Results: A total of 16 studies for tendon-ligament and 6 studies for osteochondral grafts met inclusion criteria. For all graft types, dropping the tissue onto the operating room floor is the most commonly reported method of contamination. The most common decontaminants used were 10 % povidone-iodine and 4 % chlorhexidine with the typical soaking time being 10 min. For both tissue types, chlorhexidine-based protocols were most consistently effective at eradicating bacterial contaminants. Clinical outcome measures were limited to assessments of subsequent infections with none reported in the very few studies that provided outcome data. Conclusion: The currently available evidence for intraoperative decontamination of musculoskeletal autografts and allografts supports the use of chlorhexidine-based soaking protocols for treatment of tendon autografts and allografts, as well as fresh (viable) osteochondral allografts, in order to most effectively prevent related infections. Additional data is required to determine optimal protocols with respect to disinfectant types and concentrations, inclusion of antibiotics, exposure durations, and use of "mechanical agitation" that sufficiently eradicate pathogens and preserve essential cell viability, material properties, and biocompatibility for each tissue type in order to prevent tissue waste, morbidity, complications, failures, and associated costs while promoting successful outcomes for patients.

Indexed as

Chlorhexidine-based soaking protocolsDecontaminationGraft salvageMusculoskeletal allograftsMusculoskeletal autografts

Identifiers

PMID40787434
PMCPMC12328676

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.