title: Validation of Synovial Aspiration in Girdlestone Hips for Detection of Infection Persistence in Patients Undergoing 2-Stage Revision Total Hip Arthroplasty.
abstract: BACKGROUND
  The aim of this study was to assess the diagnostic performance of synovial aspiration in Girdlestone hips, without a Polymethylmethacrylate (PMMA) spacer, for the detection of infection persistence before total hip arthroplasty (THA) reimplantation.
  
  
  METHODS
  Seventy-four patients undergoing stage revision THA surgery were included in this retrospective cohort study. Both synovial cultures and serum C-reactive protein values were acquired before explantation of the THA and of the Girdlestone hip before reimplantation.
  
  
  RESULTS
  The diagnostic performance of the synovial aspiration of the Girdlestone hip achieved a sensitivity of only 13% and a specificity of 98%. The determination of the serum C-reactive protein value for Girdlestone hips achieved a sensitivity of 95% and a specificity of only 20%.
  
  
  CONCLUSIONS
  Our data show that the Girdlestone aspiration can neither reliably confirm nor exclude a persistence of infection.
authors.affiliation: Orthopaedic Department, Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Germany.
authors.forename: Viktor
authors.initials: V
authors.lastname: Janz
authors.affiliation: Orthopaedic Department, Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Germany; Charité, Universitätsmedizin Berlin, Orthopaedic Department Berlin, Germany.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Bartek
authors.affiliation: Orthopaedic Department, Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Germany; Charité, Universitätsmedizin Berlin, Orthopaedic Department Berlin, Germany.
authors.forename: Georgi I
authors.initials: GI
authors.lastname: Wassilew
authors.affiliation: Orthopaedic Department, Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Germany; Charité, Universitätsmedizin Berlin, Orthopaedic Department Berlin, Germany.
authors.forename: Malte
authors.initials: M
authors.lastname: Stuhlert
authors.affiliation: Orthopaedic Department, Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Germany; Charité, Universitätsmedizin Berlin, Orthopaedic Department Berlin, Germany.
authors.forename: Carsten F
authors.initials: CF
authors.lastname: Perka
authors.affiliation: Orthopaedic Department, Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Germany; Charité, Universitätsmedizin Berlin, Orthopaedic Department, Center for Septic Surgery Berlin, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Winkler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D006621:Hip Joint / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016459:Prosthesis-Related Infections / Q000175:diagnosis*; D012086:Reoperation; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013582:Synovial Fluid / Q000382:microbiology*
chemical_list: D002097:C-Reactive Protein
keywords: Girdlestone; PJI; Synovial aspiration; THA revision; infection