Aspiration as a guide to sepsis in revision total hip arthroplasty

One hundred sixty-five patients underwent 171 preoperative aspiration arthrograms to evaluate a painful total hip arthroplasty. Intraoperative cultures and histologic specimens were obtained in all cases. Of the 166 aspirations where fluid was obtained, there were 140 true negative, 5 true positive,...

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Bibliographic Details
Published in:The Journal of arthroplasty 1996-08, Vol.11 (5), p.543-547
Main Authors: Fehring, Thomas K., Cohen, Bruce
Format: Article
Language:English
Subjects:
Arthrography
arthroplasty
aspiration
False Positive Reactions
hip
Hip Prosthesis - adverse effects
Humans
infection
Pain - etiology
Prosthesis-Related Infections - diagnosis
Prosthesis-Related Infections - microbiology
Sensitivity and Specificity
sepsis
Sepsis - diagnosis
Staphylococcus epidermidis - isolation & purification
Suction
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Summary:One hundred sixty-five patients underwent 171 preoperative aspiration arthrograms to evaluate a painful total hip arthroplasty. Intraoperative cultures and histologic specimens were obtained in all cases. Of the 166 aspirations where fluid was obtained, there were 140 true negative, 5 true positive, 18 false positive, and 3 false negative cultures. Sensitivity of hip aspiration to identify periprosthetic sepsis correctly was 50%; specificity was 88%. Hip aspiration with a 50% sensitivity rate lacks the ability to consistently predict those patients with occult periphrosthetic sepsis. The routine use of aspiration in evaluation of a painful total hip is probably not indicated. Selective use in patients with a history of wound healing problems, radiographic changes, and elevated laboratory values should be considered.
ISSN:0883-5403
1532-8406
DOI:10.1016/S0883-5403(96)80107-0