Multiple deep tissue cultures in primary total hip arthroplasty: prognostic value for periprosthetic infection

• Published in: Hip international 2022-01, Vol.32 (1), p.45-50
• Main Authors: Ferro, Fernando P, Bessa, Felipe S, Miyahara, Hélder, Ejnisman, Leandro, Vicente, Jose RN, Croci, Alberto T
• Format: Article
• Language: English
• Subjects: Arthroplasty, Replacement, Hip - adverse effects; Humans; Prognosis; Prosthesis-Related Infections - diagnosis; Prosthesis-Related Infections - epidemiology; Prosthesis-Related Infections - etiology; Quality of Life; Reoperation; Retrospective Studies
• ISSN: 1120-7000; 1724-6067
• DOI: 10.1177/1120700020932110

Background: The risk of infection after total hip replacement (THR) is significant, with negative impact on quality of life and high costs. Bacteria can contaminate the surgical site despite aseptic techniques; however, there is debate regarding the benefit of identifying bacteria during the primary procedure. Although taking multiple samples for culture is a well-established practice in revision arthroplasty, doing so in primary cases remains controversial. We aimed to investigate whether there is a prognostic value in the culture of samples taken during primary THR, seeking a correlation between the positivity of the cultures and subsequent prosthetic joint infection (PJI). Methods: Deep samples (capsule, femoral and acetabular bone) were collected from 426 patients undergoing elective primary THR. Follow-up was at least 3 years. Microbiological profiles of cultures were analysed. Patient data were reviewed for the identification of risk factors presumably associated with a higher risk of PJI. Results: 54 surgeries (12.6%) had positive cultures. 16 cases (3.8%) developed infection, of which 5 had a positive culture in the primary surgery. Infection rate was 9.3% in patients with positive culture and 3% in those with negative culture (p