title: The fate of the unexpected positive intraoperative cultures after revision total knee arthroplasty.
abstract: Of a consecutive series of 692 revision total knees at 3 centers, intraoperative cultures were unexpectedly found to be positive in 41 cases (5.9%). Of the 41, 29 (71%) cases had a single positive intraoperative culture and were determined to be a probable false positive based on absence of any other evidence of infection, of which 5 were treated with extended course of intravenous antibiotics after hospital discharge and the remaining 24 received no further treatment. None of these 24 patients manifested any sign of infection at follow-up, averaging 46 months (range, 24-74 months). Twelve patients were determined to have probable type 1 periprosthetic infection, 11 of which were treated with a course of antibiotics. Two of these patients became reinfected within a year. A single positive intraoperative culture after revision total knee arthroplasty does not mandate further treatment in the absence of any other signs of infection.
authors.affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, St Louis, Missouri 63110, USA.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Barrack
authors.forename: Ajay
authors.initials: A
authors.lastname: Aggarwal
authors.forename: R Stephen J
authors.initials: RS
authors.lastname: Burnett
authors.forename: John C
authors.initials: JC
authors.lastname: Clohisy
authors.forename: Elie
authors.initials: E
authors.lastname: Ghanem
authors.forename: Peter
authors.initials: P
authors.lastname: Sharkey
authors.forename: Javad
authors.initials: J
authors.lastname: Parvizi
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D019645:Arthroplasty, Replacement, Knee; D005189:False Positive Reactions; D006801:Humans; D007432:Intraoperative Period; D007719:Knee Joint / Q000382:microbiology*; D016459:Prosthesis-Related Infections / Q000175:diagnosis; D012086:Reoperation