title: Incidence of bacterial contamination in primary THA and combined hardware removal: analysis of preoperative aspiration and intraoperative biopsies.
abstract: Prior fracture surgery in the setting of subsequent arthroplasty may confer an increased risk of infection. The current authors retrospectively reviewed 122 patients from 2006 to 2010. Joint aspirations performed preoperatively in two of 52 patients revealed bacterial growth. Preoperative CRP levels were elevated in 22.8% with a mean value of 10.4 mg/L (range 5.5 to 33.3). Intra-operative cultures were performed in 109 patients, with a single patient sample exhibiting bacterial growth (0.9%). Preoperative aspiration showed a sensitivity of 1.0 and specificity of 0.98 (P<0.039) for bacterial contamination. There was no postoperative periprosthetic infection noted. In conclusion the retrieval of internal fixation devices and total hip arthroplasty can be performed safely as a single stage procedure without significantly increasing the risk of periprosthetic infection.
authors.affiliation: Orthopaedic Surgery, HELIOS ENDO-Klinik Hamburg, Hamburg, Germany; Department of Trauma, Hand and Reconstructive Surgery, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Till O
authors.initials: TO
authors.lastname: Klatte
authors.forename: Ralf
authors.initials: R
authors.lastname: Meinicke
authors.forename: Padhraig
authors.initials: P
authors.lastname: O'Loughlin
authors.forename: Johannes M
authors.initials: JM
authors.lastname: Rueger
authors.forename: Thorsten
authors.initials: T
authors.lastname: Gehrke
authors.forename: Daniel
authors.initials: D
authors.lastname: Kendoff
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D001706:Biopsy; D020878:Device Removal; D004866:Equipment Contamination; D005260:Female; D005264:Femoral Fractures / Q000382:microbiology / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000295:instrumentation; D006622:Hip Prosthesis / Q000382:microbiology*; D006801:Humans; D007592:Joint Diseases / Q000382:microbiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010027:Osteotomy; D016459:Prosthesis-Related Infections / Q000382:microbiology*; D013396:Suction; D055815:Young Adult
keywords: aspiration; bacterial contamination; fixation-devices; infection; infection salvage hip arthroplasty; periprosthetic hip infection; revision hip arthroplasty