Accuracy of Joint Aspiration for the Preoperative Diagnosis of Infection in Total Hip Arthroplasty

Ali, Farhan; Wilkinson, JM; Cooper, Jeff; Kerry, R. M.; Hamer, A. J.; Norman, P.; Stockley, I

doi:10.1016/j.arth.2005.05.027

Cited by 141 publications

(103 citation statements)

References 18 publications

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“…All study patients complained of pain at the arthroplasty site. Infection of the prosthesis was considered highly probable, based on the following preoperative parameters [8]: When at least one of these parameters was observed, and in cases where no fluid was obtained from the joint by aspiration, a PIB was done.…”

Section: Methodsmentioning

confidence: 99%

“…The patient is taken off any antibiotic treatment for a minimum of 14 days [7,8]. The patient is admitted to the orthopaedic unit.…”

Section: Pib Technique Protocolmentioning

confidence: 99%

“…The final diagnosis of infection was made when the patient met at least one of the following criteria [8,[10][11][12][13]: This article examines diagnostic accuracy for causal bacteria using sample cultures obtained through PIB in the preoperative period in patients with risk of infection and dry joint aspiration. We compared the results of preoperative PIB with those of cultures from intraoperative tissue biopsies.…”

Section: Pib Technique Protocolmentioning

confidence: 99%

“…This technique carries some limitations. First, studies of preoperative joint aspiration show a wide variation in sensitivity values, ranging between 0.11 and 1.00 [6][7][8]. Low sensitivity values for fluid aspirates in chronic PJI are partly attributable to the fact that most micro-organisms in such infections grow in biofilms, attached to the implant surface (sessile bacteria).…”

Section: Introductionmentioning

confidence: 99%

“…This can be difficult to accomplish in cases of low-grade chronic infection, due to factors such as a paucity of organisms in the joint fluid, highly fastidious growth, the biofilm nature of PJI, and the impact of any earlier antibiotic therapy. Sampling factors such as time delay, anaerobic environment or improper laboratory practice may also play a part [1,2,[5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

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Percutaneous interface biopsy in dry-aspiration cases of chronic periprosthetic joint infections: A technique for preoperative isolation of the infecting organism

Corona

Gil

Guerra

et al. 2011

International Orthopaedics (SICOT)

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Purpose Preoperative identification of the infecting microorganism is of paramount importance in the treatment protocol for chronic periprosthetic joint infections, as it enables selection of the most appropriate antibiotic treatment. Preoperative joint aspiration, the most commonly used sampling technique, has proven to have a broad range of sensitivity values and the frequency of dry aspirations has not been well assessed. In such dry-tap cases a biopsy sample could be an option. The purpose of this study was to assess the diagnostic accuracy of percutaneous interface biopsy (PIB) in isolating the infecting organism in cases of chronic Periprosthetic Joint Infection (PJI) and dry-tap event. The basic technique is to harvest and culture a sample from the periprosthetic interface membrane by a percutaneous technique in the preoperative period. Methods A retrospective study was done involving 24 consecutive patients suspected of PJI and where no fluid was obtained from the joint. Culture results from a percutaneous interface biopsy (PIB) were compared with intraoperative tissue cultures at the time of revision surgery. In all cases, a two-stage replacement was done. Results The sensitivity was 88.2%; specificity was 100%. Positive predictive value was 100%, while negative predictive value was 77.9%. Accuracy was 91.6%. No technique-related complication was observed. Conclusion We conclude that PIB is a useful test for preoperative isolation of the infecting organism and could play a role in cases with dry-tap joint aspirations.

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Section: Methodsmentioning

confidence: 99%

“…The patient is taken off any antibiotic treatment for a minimum of 14 days [7,8]. The patient is admitted to the orthopaedic unit.…”

Section: Pib Technique Protocolmentioning

confidence: 99%

Section: Pib Technique Protocolmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Percutaneous interface biopsy in dry-aspiration cases of chronic periprosthetic joint infections: A technique for preoperative isolation of the infecting organism

Corona

Gil

Guerra

et al. 2011

International Orthopaedics (SICOT)

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Bone and Joint Infections

Gillespie

2009

Evidence‐Based Infectious Diseases

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Polylactic‐co‐glycolic acid microspheres added to fixative cements and its role on bone infected architecture

et al. 2019

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Joint prostheses are an essential element to improve quality of life. However, prostheses may fail due to several factors, including the most frequent cause, Staphylococcus aureus infection. The identification of new fixing bone cements with less reactivity on bone tissue and an adequate response to infection remains a primary challenge. The aim of this study is to evaluate the response of bone tissue in rabbits after introduction of a hydroxyapatite‐coated titanium rod with a commercial fixative cement (Palacos®) compared to a modified experimental cement (EC) containing polylactic‐co‐glycolic acid (PLGA) microspheres in the presence or absence of contaminating germs. This study used 20 New Zealand rabbits which were divided into four groups (n = 5) depending on the presence or absence of S. aureus and the use of commercial (Palacos®) or EC. A histological method, based on bone architecture damage, was proposed to evaluate from 1 to 9 the histological results and the response of the infected tissue. The macrophage response was also evaluated using monoclonal antibody RAM‐11. The study showed better bone conservation with the use of EC with PLGA microspheres against the Palacos® commercial cement, including the noncontaminated and contaminated groups. © 2019 The Authors. Journal of Biomedical Materials Research Part B: Applied Biomaterials published by Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B:2517–2526, 2019.

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Accuracy of Joint Aspiration for the Preoperative Diagnosis of Infection in Total Hip Arthroplasty

Cited by 141 publications

References 18 publications

Percutaneous interface biopsy in dry-aspiration cases of chronic periprosthetic joint infections: A technique for preoperative isolation of the infecting organism

Percutaneous interface biopsy in dry-aspiration cases of chronic periprosthetic joint infections: A technique for preoperative isolation of the infecting organism

Bone and Joint Infections

Polylactic‐co‐glycolic acid microspheres added to fixative cements and its role on bone infected architecture

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