Abstract
Aims
The purpose of this study was to evaluate the infection-free outcome of patients underwent revision of total joint arthroplasty (TJA) for presumed aseptic causes, with positive intra-operative cultures.
Patients and Methods
A retrospective cohort study was assembled with 130 patients undergoing revision knee (21 cases) or hip arthroplasty (109 cases) for presumed aseptic causes. For all patients five to seven separate intra-operative cultures were obtained and prosthesis sonication was done. Patients were diagnosed with a previously unsuspected prosthetic joint infection (PJI) if two or more cultures were
positive or a positive prosthesis sonication. Data were reviewed for demographic details, preoperative laboratory results and culture results. The endpoint was infection-free implant survival at 24 months.
Results
Patients with unsuspected PJI was 16 out of 130 (12,3%). Following revision surgery, the rate of infection-free implant survival in patients with an unsuspected PJI was 68,8% (95% confidence intervals (CI) 45,6 to 92) at two years compared
with 94,7% (95% CI 90,5 to 98,9) in patients without PJI (p = 0.001).
Conclusion
Around 12% of positive cultures can be expected after TJA aseptic revision surgery; in these cases, the rate of infection-free implant survival is lower than in cases without PJI.
