S F Journeaux

Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, England, United Kingdom

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Publications (6)7.49 Total impact

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    ABSTRACT: Allograft donations are not uncommonly found to be contaminated. The issue of contaminated donations from live donors at the time of surgery, and the significance of this to the patient in terms of subsequent sepsis of the arthroplasty, were examined. The donations of femoral heads to the Queensland Bone Bank over a 9-year period were reviewed, and the incidence and bacteriology of contamination were detailed. Clinical outcomes were determined for donors who had positive cultures at the time of retrieval and they were compared with those of culture-negative donors. Between March 1987 and February 1996, 232 femoral heads were donated to the Queensland Bone Bank. Four specimens were sent for culture with each femoral head (surface swab of femoral head, acetabular swab, bone biopsy and capsule). In 51 cases, one or more positive cultures were obtained (22% contamination rate). The majority of organisms cultured were Staphylococcus epidermidis. One hundred and seventy donations came from surgery performed at the Princess Alexandra Hospital, and 40 femoral heads were considered contaminated. Deep infection was recorded in one of the 40 cases with contaminated donations and three out of 130 non-contaminated donations had subsequent septic episodes. The contamination rate detailed in the present report is higher than in most series. This may be due to the fact that four bacteriological specimens are taken to assess contamination. Two of these specimens are tissue samples which yielded more positive results than did the two swabs. All other series take no more than two bacteriological specimens, which are usually bone swabs. These are shown to have a poor yield of positive cultures. Therefore there is a significant underestimation of contamination rates by other bone banks. This has implications for the recipients of bone from those banks, particularly when the allograft material is not secondarily sterilized. This is important given increasing allograft usage, and the increasing numbers of revision joint arthroplasty and impaction grafting procedures being performed. Sterilization of all bone by irradiation to 25 kGy is recommended.
    Australian and New Zealand Journal of Surgery 08/2000; 70(7):480-4.
  • Source
    S F Journeaux, D A Morgan, W J Donnelly
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    ABSTRACT: We reviewed 120 consecutive primary total hip replacements in 109 patients in whom a Freeman uncemented metal-backed component had been used. Acetabular components were used with a Freeman neck-retaining stem in one of three configurations: cemented smooth stem, uncemented smooth stem or uncemented ridged stem. After a mean follow up of 72 months (62 to 113) there were nine cases of aseptic loosening; a survivorship at eight years of 83%. In addition, more than one-third of the remaining surviving cups showed loosening radiologically. The Freeman acetabular component demonstrated a characteristic pattern of loosening on radiographs. The high incidence of aseptic loosening can be explained by poor design and material failure.
    Journal of Bone and Joint Surgery - British Volume 04/2000; 82(2):185-7. · 2.69 Impact Factor
  • Source
    S F Journeaux, D A Morgan, W J Donnelly
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    ABSTRACT: We have reviewed 202 consecutive primary hip replacements using a Freeman cemented femoral component after a mean period of follow-up of 64 months (23 to 113). There was only one revision for aseptic loosening. Retention of the femoral neck may act to reduce the torsional and shear forces at the implant-cement interface and may provide a seal against the migration of polyethylene-laden joint fluid in the potential joint space. The cemented Freeman femoral component with retention of the femoral neck was successful for up to nine years.
    Journal of Bone and Joint Surgery - British Volume 04/2000; 82(2):188-91. · 2.69 Impact Factor
  • Source
    S. F. Journeaux, D. A. F. Morgan, W. J. Donnelly
    Journal of Bone and Joint Surgery-british Volume - J BONE JOINT SURG-BRIT VOL. 01/2000; 82(2):185-187.
  • [Show abstract] [Hide abstract]
    ABSTRACT: A retrospective study of allograft bone retrieved from 401 donors between January 1987 and March 1996 was performed to determine the incidence of bacterial contamination. Contamination according to type of donor (live, multiorgan, cadaveric) was also determined. Live donors donating a femoral head demonstrated a contamination rate of 13%; multiorgan donors, 24%; and cadaveric donors, 35%. Donor contamination by type of bone (hemipelvis, femur, tibia) showed no significant difference in the multiorgan donors. In cadaveric donors, there was a significant increase in contamination of the hemipelves as compared to the femur and tibias. Recommendations for contamination control in allograft retrieval are given. Our findings are of great significance for musculoskeletal banks that do not secondarily irradiate and rely on screening of allograft bone for contamination alone.
    The Journal of Arthroplasty 10/1999; · 2.11 Impact Factor
  • S L Bryce, S F Journeaux
    Australian and New Zealand Journal of Surgery 09/1996; 66(8):562-3.

Publication Stats

90 Citations
7.49 Total Impact Points

Institutions

  • 2000
    • Royal Liverpool and Broadgreen University Hospitals NHS Trust
      Liverpool, England, United Kingdom
  • 1996–2000
    • Princess Alexandra Hospital (Queensland Health)
      Brisbane, Queensland, Australia
  • 1999
    • The Princess Alexandra Hospital NHS Trust
      Harlow, England, United Kingdom