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Role of joint aspiration before re-implantation in patients with a cement spacer in place

BACKGROUND: The usefulness of a mandatory joint aspiration before re-implantation in patients with a cement spacer already in place is unclear. AIM: To evaluate the role of culturing synovial fluid obtained by joint aspiration before re-implantation in patients who underwent a two-stage septic revis...

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Detalles Bibliográficos
Autores principales: Huguet, Sandra, Bernaus, Martí, Gómez, Lucía, Cuchí, Eva, Soriano, Alex, Font-Vizcarra, Lluís
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9244963/
https://www.ncbi.nlm.nih.gov/pubmed/35949711
http://dx.doi.org/10.5312/wjo.v13.i6.615
Descripción
Sumario:BACKGROUND: The usefulness of a mandatory joint aspiration before re-implantation in patients with a cement spacer already in place is unclear. AIM: To evaluate the role of culturing synovial fluid obtained by joint aspiration before re-implantation in patients who underwent a two-stage septic revision. METHODS: A retrospective observational study was conducted, including patients that underwent a two-stage septic revision (hip or knee) from 2010 to 2017. After the first stage revision and according to intraoperative culture results, all patients were treated with an antibiotic protocol for 6-8 wk. Following 2 wk without antibiotics, a culture of synovial fluid was obtained. The results of these cultures were recorded and compared with cultures obtained during re-implantation surgery. RESULTS: Forty-one patients (20 hip and 21 knee spacers) were included in the final analysis. In 39 cases, the culture of synovial fluid was negative, while in the remaining 2 cases (knee spacers) no analysis was possible due to dry tap. In 5 of the patients, two or more intraoperative cultures taken during the re-implantation surgery were positive. CONCLUSION: We found no evidence to support mandatory joint aspiration before re-implantation in patients with a cement spacer in place.