Sandra Huguet1,2, Martí Bernaus3,4, Lucía Gómez4,5, Eva Cuchí4,6, Alex Soriano7, Lluís Font-Vizcarra3,4. 1. Department of Traumatology and Orthopaedics, Hospital Universitari Mútua Terrassa, Barcelona, Spain. sanhumi@gmail.com. 2. Department of Traumatology and Orthopaedics, Consorci Sanitari de l'Alt Penedès - Garraf, Barcelona, Spain. sanhumi@gmail.com. 3. Department of Traumatology and Orthopaedics, Hospital Universitari Mútua Terrassa, Barcelona, Spain. 4. Osteoarticular Infections Unit, Hospital Universitari Mútua Terrassa, Barcelona, Spain. 5. Infectious Diseases Unit, Hospital Universitari Mútua Terrassa, Barcelona, Spain. 6. Department of Microbiology, CATLAB, Viladecavalls, Barcelona, Spain. 7. Department of Infectious Diseases - Osteoarticular Infections Unit, Hospital Clínic, Barcelona, Spain.
Abstract
PURPOSE: In two-stage replacements for septic loosening, some studies have suggested an association between bacterial colonisation of spacers and a higher number of complications after implantation of the definitive prosthesis. Our study aimed to determine the reoperation rate of patients undergoing two-stage revision surgery according to the culture results of spacer sonication. METHODS: A retrospective observational study was conducted in which hip or knee spacers implanted at our institution with a diagnosis of periprosthetic joint infection from 2010 to 2018 were analysed. Patients were grouped into three categories: A. Patients with positive spacer sonication fluid culture, with or without positive cultures of the rest of the samples. B. Patients with negative spacer sonication culture and negative cultures of the rest of intraoperative samples. C. Patients with negative spacer sonication culture but positive cultures of the rest of intraoperative samples. RESULTS: A total of 45 spacers were analysed: 10 were included in group A, 24 in group B and 11 in group C. The reoperation rate during the first year after the 2-stage revision surgery was 20%, 29.2% and 54.5% for each group, respectively, due to an infection in 10%, 20.8% and 45.5%. Spacers were colonised in all cases by low virulent micro-organisms. CONCLUSION: In our study, bacterial colonisation of the spacer is not associated with a higher rate of reoperation. The group of patients with positive intraoperative cultures during the second-stage had the highest reoperation rate.
PURPOSE: In two-stage replacements for septic loosening, some studies have suggested an association between bacterial colonisation of spacers and a higher number of complications after implantation of the definitive prosthesis. Our study aimed to determine the reoperation rate of patients undergoing two-stage revision surgery according to the culture results of spacer sonication. METHODS: A retrospective observational study was conducted in which hip or knee spacers implanted at our institution with a diagnosis of periprosthetic joint infection from 2010 to 2018 were analysed. Patients were grouped into three categories: A. Patients with positive spacer sonication fluid culture, with or without positive cultures of the rest of the samples. B. Patients with negative spacer sonication culture and negative cultures of the rest of intraoperative samples. C. Patients with negative spacer sonication culture but positive cultures of the rest of intraoperative samples. RESULTS: A total of 45 spacers were analysed: 10 were included in group A, 24 in group B and 11 in group C. The reoperation rate during the first year after the 2-stage revision surgery was 20%, 29.2% and 54.5% for each group, respectively, due to an infection in 10%, 20.8% and 45.5%. Spacers were colonised in all cases by low virulent micro-organisms. CONCLUSION: In our study, bacterial colonisation of the spacer is not associated with a higher rate of reoperation. The group of patients with positive intraoperative cultures during the second-stage had the highest reoperation rate.
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