title: Aspiration as a guide to sepsis in revision total hip arthroplasty.
abstract: 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 periprosthetic 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.
authors.affiliation: Charlotte Orthopedic Specialists, P.A., NC 28204, USA.
authors.forename: T K
authors.initials: TK
authors.lastname: Fehring
authors.forename: B
authors.initials: B
authors.lastname: Cohen
mesh_terms: D001175:Arthrography; D005189:False Positive Reactions; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D010146:Pain / Q000209:etiology; D016459:Prosthesis-Related Infections / Q000175:diagnosis* / Q000382:microbiology; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000175:diagnosis; D013212:Staphylococcus epidermidis / Q000302:isolation & purification; D013396:Suction