Contamination Risk of Synovial Biopsy Cultures in Total Hip Arthroplasty: A Prospective Review of 100 Cases

2017 ◽  
Vol 27 (6) ◽  
pp. 595-598
Author(s):  
Christophe Pattyn ◽  
Thomas De Bo ◽  
Joris Anthonissen ◽  
Philippe Willekens ◽  
Geert Claeys ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
False Positive ◽  
Healthy Subjects ◽  
Joint Infection ◽  
Revision Arthroplasty ◽  
Synovial Biopsy ◽  
Total Hip ◽  
Contamination Risk ◽  
Primary Total Hip Arthroplasty

Introduction Cultures of deep synovial biopsies remain an important tool in diagnosing periprosthetic joint infection, a devastating complication following total hip arthroplasty (THA). Recent reports of unexpected positive intraoperative cultures in aseptic revision arthroplasty, however, challenge the validity and interpretation of these cultures. The aim of this study was to evaluate the contamination risk of synovial biopsy cultures collected intraoperatively during primary THA of healthy subjects. Methods Synovial biopsies for culture were collected during primary total hip arthroplasty procedures from 100 consecutive cases. The synovial biopsies were taken within the first 15 minutes after skin incision. Biopsy specimen were cultured on 4 different media for 8 or 15 days. Positive cultures were identified using Maldi-Tof spectrometry. Results 16 cultures yielded a bacterium, suggesting a false positive result of 16%. The mean time for the cultures to become positive was 6.29 days (standard deviation [SD] 3.90) with a maximum of 15 days. Proprionibacterium acnes and Staphylococcus epidermidis were most commonly cultured with 6 positive results for both bacteria. Conclusions Our study yielded a 16% false positive rate in cultures of synovial biopsy taken during primary total hip arthroplasty of healthy subjects, suggesting that contamination risk of these synovial biopsy cultures may be larger than assumed by clinicians.

scholarly journals DOES TOPICAL USE OF GENTAMICIN REDUCE THE INFECTION RATE IN PRIMARY TOTAL HIP ARTHROPLASTY?

2019 ◽  
Vol 27 (4) ◽  
pp. 197-201 ◽  
Author(s):  
Caio Luiz de Toledo Oliveira ◽  
Felipe Abrahão Elias ◽  
André dos Santos Ribacionka ◽  
Celso Hermínio Ferraz Picado ◽  
Flávio Luís Garcia
Keyword(s):  
Total Hip Arthroplasty ◽  
Antibiotic Prophylaxis ◽  
Hip Arthroplasty ◽  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
University Hospital ◽  
Fisher Exact Test ◽  
Infection Rates ◽  
Total Hip ◽  
Primary Total Hip Arthroplasty

ABSTRACT Objective: To determine whether the topical use of gentamicin reduces periprosthetic joint infection rates in primary total hip arthroplasty (THA). Methods: We retrospectively evaluated two cohorts of patients who underwent primary THA in a university hospital, with a minimum of 1-year postoperative follow-up and full clinical, laboratory, and radiological documentation. Patients who underwent operation in the first 59 months of the study period (263 hips) received only intravenous cefazolin as antibiotic prophylaxis (Cef group), and those who underwent operation in the following 43 months (170 hips) received intravenous cefazolin plus topical gentamicin directly applied on the wound as antibiotic prophylaxis (Cef + Gen group). For the diagnosis of periprosthetic joint infection, we used the criteria of the Centers for Disease Control and Prevention. Data were analyzed using the Fisher exact test, and p values of <0.05 were considered significant. Results: Thirteen hips (4.9%) in the Cef group and eight hips (4.7%) in the Cef + Gen group presented periprosthetic joint infection. Statistical analysis revealed no difference between the infection rates (p = 1.0). Conclusion: Topical gentamicin as used in this study did not reduce periprosthetic joint infection rates in primary THA. Level of Evidence III, Retrospective comparative study.

scholarly journals Total Hip Arthroplasty with Tantalum Constructions

2012 ◽  
Vol 19 (1) ◽  
pp. 24-29
Author(s):  
V Yu Murylev ◽  
Dmitriy Igorevich Terent'ev ◽  
P M Elizarov ◽  
Ya A Rukin ◽  
G M Kazaryan ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Revision Arthroplasty ◽  
Acetabular Reconstruction ◽  
Defect Classification ◽  
Common Complication ◽  
Total Hip ◽  
Primary Arthroplasty ◽  
Selection Of ◽  
Primary Total Hip Arthroplasty

Results of acetabular reconstruction with tantalum constructions were analyzed for 56 patients (25 men and 31 women) aged 35 to 70 years. Primary arthroplasty was performed in 30 and revision intervention in 26 patients. In case of primary total hip arthroplasty the following etiologic factors were considered: posttraumatic acetabulum deformity (21 patients), deficit of acetabular walls resulted from dysplasia (4), femoral head protrusion (5). Evaluation of the defect and selection of tantalum construction were made using defect classification by W.G. Paprosky. Results were assessed by Harris scale at terms 3,6 and 12 months after operation and every year thereafter. Excellent, good and satisfactory results were achieved in 96.8% of cases. The most common complication was the dislocation of hip implant head. It developed in 2 patients after revision arthroplasty and in 1 patient after primary total hip arthroplasty.

scholarly journals Is the use of antibiotic-loaded bone cement associated with a lower risk of revision after primary total hip arthroplasty?

2020 ◽  
Vol 102-B (8) ◽  
pp. 997-1002
Author(s):  
Justin W. Leong ◽  
Michael J. Cook ◽  
Terence W. O’Neill ◽  
Timothy N. Board
Keyword(s):  
Total Hip Arthroplasty ◽  
Bone Cement ◽  
Aseptic Loosening ◽  
Hip Arthroplasty ◽  
Proportional Hazards ◽  
Joint Infection ◽  
Cox Proportional Hazards ◽  
Total Hip ◽  
Joint Registry ◽  
Primary Total Hip Arthroplasty

Aims The aim of this study was to investigate whether the use of antibiotic-loaded bone cement influenced the risk of revision surgery after primary total hip arthroplasty (THA) for osteoarthritis. Methods The study involved data collected by the National Joint Registry (NJR) for England and Wales, Northern Ireland and the Isle of Man between 1 September 2005 and 31 August 2017. Cox proportional hazards were used to investigate the association between use of antibiotic-loaded bone cement and the risk of revision due to prosthetic joint infection (PJI), with adjustments made for the year of the initial procedure, age at the time of surgery, sex, American Society of Anesthesiologists (ASA) grade, head size, and body mass index (BMI). We looked also at the association between use of antibiotic-loaded bone cement and the risk of revision due to aseptic loosening or osteolysis. Results The cohort included 418,857 THAs of whom 397,896 had received antibiotic-loaded bone cement and 20,961 plain cement. After adjusting for putative confounding factors, the risk of revision for PJI was lower in those in whom antibiotic-loaded bone cement was used (hazard ration (HR) 0.79; 95% confidence interval (CI) 0.64 to 0.98). There was also a protective effect on the risk of revision due to aseptic loosening or osteolysis, in the period of > 4.1 years after primary THA, HR 0.57, 95% CI 0.45, 0.72. Conclusion Within the limits of registry analysis, this study showed an association between the use of antibiotic-loaded bone cement and lower rates of revision due to PJI. The findings support the continued use of antibiotic-loaded bone cement in cemented THA. Cite this article: Bone Joint J 2020;102-B(8):997–1002.

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