title: Unexpected positive intraoperative cultures in aseptic revision arthroplasty.
abstract: Unexpected positive intraoperative cultures (UPIC) in presumed aseptic revision arthroplasty can be difficult to interpret. The purpose of this retrospective study was to compare the incidence of subsequent periprosthetic joint infection (PJI) in patients who received antibiotic therapy according to an institutional protocol with those who did not and whether they meet Musculoskeletal Infection Society (MSIS) criteria for PJI. In patients who were treated with antibiotic according to institutional criteria, the incidence of PJI after revision was higher in those who did not meet MSIS criteria (22%) than in those that met MSIS criteria (14%; P > 0.71). UPIC in aseptic revision arthroplasty are not uncommon. PJI cannot be excluded in patients that do not meet MSIS definition.
authors.affiliation: Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Anas
authors.initials: A
authors.lastname: Saleh
authors.affiliation: Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Albair
authors.initials: A
authors.lastname: Guirguis
authors.affiliation: Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Alison K
authors.initials: AK
authors.lastname: Klika
authors.affiliation: Department of Infectious Disease, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Lucileia
authors.initials: L
authors.lastname: Johnson
authors.affiliation: Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Higuera
authors.affiliation: Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Wael K
authors.initials: WK
authors.lastname: Barsoum
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D016459:Prosthesis-Related Infections / Q000175:diagnosis* / Q000209:etiology / Q000382:microbiology / Q000628:therapy; D012086:Reoperation; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents
keywords: aseptic revision arthroplasty; intraoperative cultures; periprosthetic joint infection; revision hip arthroplasty; revision knee arthroplasty