Cargando…
The Role of Single Positive Cultures in Presumed Aseptic Total Hip and Knee Revision Surgery—A Systematic Review of the Literature
(1) Background: Prior to revision hip (THA) or knee arthroplasty (TKA), periprosthetic low-grade infection (PJI) should be ruled out. Despite advances in preoperative diagnosis, unsuspected positive cultures (UPCs) may occur in initially planned aseptic revisions. Particularly, single UPCs pose a di...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10178370/ https://www.ncbi.nlm.nih.gov/pubmed/37175046 http://dx.doi.org/10.3390/diagnostics13091655 |
_version_ | 1785040845771112448 |
---|---|
author | Schwarze, Jan Moellenbeck, Burkhard Gosheger, Georg Puetzler, Jan Deventer, Niklas Kalisch, Tobias Schneider, Kristian Nikolaus Klingebiel, Sebastian Theil, Christoph |
author_facet | Schwarze, Jan Moellenbeck, Burkhard Gosheger, Georg Puetzler, Jan Deventer, Niklas Kalisch, Tobias Schneider, Kristian Nikolaus Klingebiel, Sebastian Theil, Christoph |
author_sort | Schwarze, Jan |
collection | PubMed |
description | (1) Background: Prior to revision hip (THA) or knee arthroplasty (TKA), periprosthetic low-grade infection (PJI) should be ruled out. Despite advances in preoperative diagnosis, unsuspected positive cultures (UPCs) may occur in initially planned aseptic revisions. Particularly, single UPCs pose a diagnostic and therapeutic dilemma, as their impact on outcome is unclear and recommendations are heterogeneous. This review investigates the frequency of single UPCs and their impact on implant survivorship. (2) Methods: In July 2022, a comprehensive literature search was performed using PubMed and Cochrane Library search. In total, 197 articles were screened. Seven retrospective studies with a total of 5821 cases were able to be included in this review. (3) Results: Based on the cases included, UPCs were found in 794/5821 cases (14%). In 530/794 cases (67%), the majority of the UPCs were single positive. The most commonly isolated pathogens were coagulase negative Staphylococci and Cutibacterium acnes. Five of seven studies reported no influence on revision- or infection-free survival following a single positive culture. In two studies, single UPCs following THA revision were correlated with subsequent re-revision for PJI. (4) Conclusions: Single UPCs of a non-virulent pathogen following presumed aseptic TKA revision may be interpreted as contaminants. A single UPC following THA revision may be a risk factor for subsequent PJI. The role of systemic antibiotic treatment remains unclear, but it should be considered if other risk factors for PJI are present. |
format | Online Article Text |
id | pubmed-10178370 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-101783702023-05-13 The Role of Single Positive Cultures in Presumed Aseptic Total Hip and Knee Revision Surgery—A Systematic Review of the Literature Schwarze, Jan Moellenbeck, Burkhard Gosheger, Georg Puetzler, Jan Deventer, Niklas Kalisch, Tobias Schneider, Kristian Nikolaus Klingebiel, Sebastian Theil, Christoph Diagnostics (Basel) Systematic Review (1) Background: Prior to revision hip (THA) or knee arthroplasty (TKA), periprosthetic low-grade infection (PJI) should be ruled out. Despite advances in preoperative diagnosis, unsuspected positive cultures (UPCs) may occur in initially planned aseptic revisions. Particularly, single UPCs pose a diagnostic and therapeutic dilemma, as their impact on outcome is unclear and recommendations are heterogeneous. This review investigates the frequency of single UPCs and their impact on implant survivorship. (2) Methods: In July 2022, a comprehensive literature search was performed using PubMed and Cochrane Library search. In total, 197 articles were screened. Seven retrospective studies with a total of 5821 cases were able to be included in this review. (3) Results: Based on the cases included, UPCs were found in 794/5821 cases (14%). In 530/794 cases (67%), the majority of the UPCs were single positive. The most commonly isolated pathogens were coagulase negative Staphylococci and Cutibacterium acnes. Five of seven studies reported no influence on revision- or infection-free survival following a single positive culture. In two studies, single UPCs following THA revision were correlated with subsequent re-revision for PJI. (4) Conclusions: Single UPCs of a non-virulent pathogen following presumed aseptic TKA revision may be interpreted as contaminants. A single UPC following THA revision may be a risk factor for subsequent PJI. The role of systemic antibiotic treatment remains unclear, but it should be considered if other risk factors for PJI are present. MDPI 2023-05-08 /pmc/articles/PMC10178370/ /pubmed/37175046 http://dx.doi.org/10.3390/diagnostics13091655 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Systematic Review Schwarze, Jan Moellenbeck, Burkhard Gosheger, Georg Puetzler, Jan Deventer, Niklas Kalisch, Tobias Schneider, Kristian Nikolaus Klingebiel, Sebastian Theil, Christoph The Role of Single Positive Cultures in Presumed Aseptic Total Hip and Knee Revision Surgery—A Systematic Review of the Literature |
title | The Role of Single Positive Cultures in Presumed Aseptic Total Hip and Knee Revision Surgery—A Systematic Review of the Literature |
title_full | The Role of Single Positive Cultures in Presumed Aseptic Total Hip and Knee Revision Surgery—A Systematic Review of the Literature |
title_fullStr | The Role of Single Positive Cultures in Presumed Aseptic Total Hip and Knee Revision Surgery—A Systematic Review of the Literature |
title_full_unstemmed | The Role of Single Positive Cultures in Presumed Aseptic Total Hip and Knee Revision Surgery—A Systematic Review of the Literature |
title_short | The Role of Single Positive Cultures in Presumed Aseptic Total Hip and Knee Revision Surgery—A Systematic Review of the Literature |
title_sort | role of single positive cultures in presumed aseptic total hip and knee revision surgery—a systematic review of the literature |
topic | Systematic Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10178370/ https://www.ncbi.nlm.nih.gov/pubmed/37175046 http://dx.doi.org/10.3390/diagnostics13091655 |
work_keys_str_mv | AT schwarzejan theroleofsinglepositiveculturesinpresumedaseptictotalhipandkneerevisionsurgeryasystematicreviewoftheliterature AT moellenbeckburkhard theroleofsinglepositiveculturesinpresumedaseptictotalhipandkneerevisionsurgeryasystematicreviewoftheliterature AT goshegergeorg theroleofsinglepositiveculturesinpresumedaseptictotalhipandkneerevisionsurgeryasystematicreviewoftheliterature AT puetzlerjan theroleofsinglepositiveculturesinpresumedaseptictotalhipandkneerevisionsurgeryasystematicreviewoftheliterature AT deventerniklas theroleofsinglepositiveculturesinpresumedaseptictotalhipandkneerevisionsurgeryasystematicreviewoftheliterature AT kalischtobias theroleofsinglepositiveculturesinpresumedaseptictotalhipandkneerevisionsurgeryasystematicreviewoftheliterature AT schneiderkristiannikolaus theroleofsinglepositiveculturesinpresumedaseptictotalhipandkneerevisionsurgeryasystematicreviewoftheliterature AT klingebielsebastian theroleofsinglepositiveculturesinpresumedaseptictotalhipandkneerevisionsurgeryasystematicreviewoftheliterature AT theilchristoph theroleofsinglepositiveculturesinpresumedaseptictotalhipandkneerevisionsurgeryasystematicreviewoftheliterature AT schwarzejan roleofsinglepositiveculturesinpresumedaseptictotalhipandkneerevisionsurgeryasystematicreviewoftheliterature AT moellenbeckburkhard roleofsinglepositiveculturesinpresumedaseptictotalhipandkneerevisionsurgeryasystematicreviewoftheliterature AT goshegergeorg roleofsinglepositiveculturesinpresumedaseptictotalhipandkneerevisionsurgeryasystematicreviewoftheliterature AT puetzlerjan roleofsinglepositiveculturesinpresumedaseptictotalhipandkneerevisionsurgeryasystematicreviewoftheliterature AT deventerniklas roleofsinglepositiveculturesinpresumedaseptictotalhipandkneerevisionsurgeryasystematicreviewoftheliterature AT kalischtobias roleofsinglepositiveculturesinpresumedaseptictotalhipandkneerevisionsurgeryasystematicreviewoftheliterature AT schneiderkristiannikolaus roleofsinglepositiveculturesinpresumedaseptictotalhipandkneerevisionsurgeryasystematicreviewoftheliterature AT klingebielsebastian roleofsinglepositiveculturesinpresumedaseptictotalhipandkneerevisionsurgeryasystematicreviewoftheliterature AT theilchristoph roleofsinglepositiveculturesinpresumedaseptictotalhipandkneerevisionsurgeryasystematicreviewoftheliterature |