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Is implant sonication useful when screening for infection in conversion of prior hip fracture fixation to total hip arthroplasty?

OBJECTIVE: To examine sonication results in presumed aseptic conversion total hip arthroplasty (THA) after hip fracture fixation and to evaluate its implications on the treatment outcome. METHODS: This retrospective cohort study reviewed the data from presumed aseptic patients that underwent convers...

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Autores principales: Palmowski, Yannick, Pumberger, Matthias, Perka, Carsten, Hardt, Sebastian, Hipfl, Christian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8442504/
https://www.ncbi.nlm.nih.gov/pubmed/34515558
http://dx.doi.org/10.1177/03000605211028123
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author Palmowski, Yannick
Pumberger, Matthias
Perka, Carsten
Hardt, Sebastian
Hipfl, Christian
author_facet Palmowski, Yannick
Pumberger, Matthias
Perka, Carsten
Hardt, Sebastian
Hipfl, Christian
author_sort Palmowski, Yannick
collection PubMed
description OBJECTIVE: To examine sonication results in presumed aseptic conversion total hip arthroplasty (THA) after hip fracture fixation and to evaluate its implications on the treatment outcome. METHODS: This retrospective cohort study reviewed the data from presumed aseptic patients that underwent conversion of prior internal fixation of proximal femoral fractures to THA between 2012 and 2018. Microbiological analysis was performed using sonication of osteosynthesis material and tissue samples. Treatment outcome including the occurrence of periprosthetic joint infection (PJI) was recorded. RESULTS: A total of 32 patients were included in the study. Of these, five patients (15.6%) had positive intraoperative cultures. The mean follow-up following conversion THA was 43.0 months (range, 19.0–91.5 months). Sonication was positive in three patients (9.4%), all of whom were deemed contaminated and did not develop PJI. Tissue cultures were positive in two patients (6.3%). One patient with Enterococcus faecalis received antibiotic treatment and did not develop PJI. Another patient with growth of Cutibacterium acnes that was initially classified as a contaminant later developed acute PJI caused by the same pathogen. Overall, PJI occurred in two patients (6.3%) after conversion THA. CONCLUSION: Sonication of internal fixation devices did not add diagnostic value in clinically aseptic conversion THA. Further studies are needed to better understand the relevance of unexpected positive cultures, and to develop diagnostic criteria for the management of these patients.
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spelling pubmed-84425042021-09-16 Is implant sonication useful when screening for infection in conversion of prior hip fracture fixation to total hip arthroplasty? Palmowski, Yannick Pumberger, Matthias Perka, Carsten Hardt, Sebastian Hipfl, Christian J Int Med Res Retrospective Clinical Research Report OBJECTIVE: To examine sonication results in presumed aseptic conversion total hip arthroplasty (THA) after hip fracture fixation and to evaluate its implications on the treatment outcome. METHODS: This retrospective cohort study reviewed the data from presumed aseptic patients that underwent conversion of prior internal fixation of proximal femoral fractures to THA between 2012 and 2018. Microbiological analysis was performed using sonication of osteosynthesis material and tissue samples. Treatment outcome including the occurrence of periprosthetic joint infection (PJI) was recorded. RESULTS: A total of 32 patients were included in the study. Of these, five patients (15.6%) had positive intraoperative cultures. The mean follow-up following conversion THA was 43.0 months (range, 19.0–91.5 months). Sonication was positive in three patients (9.4%), all of whom were deemed contaminated and did not develop PJI. Tissue cultures were positive in two patients (6.3%). One patient with Enterococcus faecalis received antibiotic treatment and did not develop PJI. Another patient with growth of Cutibacterium acnes that was initially classified as a contaminant later developed acute PJI caused by the same pathogen. Overall, PJI occurred in two patients (6.3%) after conversion THA. CONCLUSION: Sonication of internal fixation devices did not add diagnostic value in clinically aseptic conversion THA. Further studies are needed to better understand the relevance of unexpected positive cultures, and to develop diagnostic criteria for the management of these patients. SAGE Publications 2021-09-13 /pmc/articles/PMC8442504/ /pubmed/34515558 http://dx.doi.org/10.1177/03000605211028123 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Retrospective Clinical Research Report
Palmowski, Yannick
Pumberger, Matthias
Perka, Carsten
Hardt, Sebastian
Hipfl, Christian
Is implant sonication useful when screening for infection in conversion of prior hip fracture fixation to total hip arthroplasty?
title Is implant sonication useful when screening for infection in conversion of prior hip fracture fixation to total hip arthroplasty?
title_full Is implant sonication useful when screening for infection in conversion of prior hip fracture fixation to total hip arthroplasty?
title_fullStr Is implant sonication useful when screening for infection in conversion of prior hip fracture fixation to total hip arthroplasty?
title_full_unstemmed Is implant sonication useful when screening for infection in conversion of prior hip fracture fixation to total hip arthroplasty?
title_short Is implant sonication useful when screening for infection in conversion of prior hip fracture fixation to total hip arthroplasty?
title_sort is implant sonication useful when screening for infection in conversion of prior hip fracture fixation to total hip arthroplasty?
topic Retrospective Clinical Research Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8442504/
https://www.ncbi.nlm.nih.gov/pubmed/34515558
http://dx.doi.org/10.1177/03000605211028123
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