A positive bacterial culture during re-implantation is associated with a poor outcome in two-stage exchange arthroplasty for deep infection

The Bone & Joint Journal
D AkgünT Winkler

Abstract

The aim of this study was to identify the incidence of positive cultures during the second stage of a two-stage revision arthroplasty and to analyse the association between positive cultures and an infection-free outcome. This single-centre retrospective review of prospectively collected data included patients with a periprosthetic joint infection (PJI) of either the hip or the knee between 2013 and 2015, who were treated using a standardised diagnostic and therapeutic algorithm with two-stage exchange. Failure of treatment was assessed according to a definition determined by a Delphi-based consensus. Logistic regression analysis was performed to assess the predictors of positive culture and risk factors for failure. The mean follow-up was 33 months (24 to 48). A total of 163 two-stage revision arthroplasties involving 84 total hip arthroplasties (THAs) and 79 total knee arthroplasties (TKAs) were reviewed. In 27 patients (16.6%), ≥ 1 positive culture was identified at re-implantation and eight (29.6%) of these subsequently failed compared with 20 (14.7%) patients who were culture-negative. The same initially infecting organism was isolated at re-implantation in nine of 27 patients (33.3%). The organism causing re-infection in ...Continue Reading

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Citations

Feb 14, 2018·The Bone & Joint Journal·F S Haddad
Nov 13, 2018·The Bone & Joint Journal·F S HaddadV Gant
Oct 4, 2018·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Marjan Wouthuyzen-BakkerAlex Soriano
Jun 23, 2020·Journal of Bone and Joint Infection·Joris BongersJon H M Goosen
Jan 5, 2020·International Orthopaedics·Xiaojun ShiFuxing Pei
Nov 18, 2018·Archives of Orthopaedic and Trauma Surgery·Tobias WinklerCarsten F Perka
Mar 15, 2019·Journal of Orthopaedic Surgery and Research·Doruk AkgünTobias Winkler
Jan 4, 2021·Archives of Orthopaedic and Trauma Surgery·O E BischelA J Suda
Jan 12, 2020·Journal of Shoulder and Elbow Surgery·Doruk AkgünPhilipp Moroder
Feb 21, 2021·The Journal of Arthroplasty·Bernhard J H FrankJochen G Hofstaetter
Apr 25, 2018·The Journal of Arthroplasty·Jaiben GeorgeCarlos A Higuera

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