Unexpected positive intraoperative cultures in aseptic revision arthroplasty

J Arthroplasty. 2014 Nov;29(11):2181-6. doi: 10.1016/j.arth.2014.07.010. Epub 2014 Jul 16.

Abstract

Unexpected positive intraoperative cultures (UPIC) in presumed aseptic revision arthroplasty can be difficult to interpret. The purpose of this retrospective study was to compare the incidence of subsequent periprosthetic joint infection (PJI) in patients who received antibiotic therapy according to an institutional protocol with those who did not and whether they meet Musculoskeletal Infection Society (MSIS) criteria for PJI. In patients who were treated with antibiotic according to institutional criteria, the incidence of PJI after revision was higher in those who did not meet MSIS criteria (22%) than in those that met MSIS criteria (14%; P > 0.71). UPIC in aseptic revision arthroplasty are not uncommon. PJI cannot be excluded in patients that do not meet MSIS definition.

Keywords: aseptic revision arthroplasty; intraoperative cultures; periprosthetic joint infection; revision hip arthroplasty; revision knee arthroplasty.

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Arthroplasty, Replacement, Knee / adverse effects*
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Prevalence
  • Prosthesis-Related Infections / diagnosis*
  • Prosthesis-Related Infections / etiology
  • Prosthesis-Related Infections / microbiology
  • Prosthesis-Related Infections / therapy
  • Reoperation
  • Retrospective Studies

Substances

  • Anti-Bacterial Agents