The Role of Single Positive Cultures in Presumed Aseptic Total Hip and Knee Revision Surgery—A Systematic Review of the Literature
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Date | Author | Journal | Title | Type | Arthroplasty | OCEBM Level of Evidence | MINOR Score |
---|---|---|---|---|---|---|---|
2007 September | Barrack et al. [33] | Journal of Arthroplasty | The fate of the unexpected positive intraoperative cultures after revision total knee arthroplasty | Retrospective, Multi Center | TKA | 3 | 17 |
2019 June | Milandt et al. [44] | Clinical Orthopaedics and Related Research | A Single Positive Tissue Culture Increases the Risk of Rerevision of Clinically Aseptic THA: A National Register Study | Retrospective, Registry Study | THA | 3 | 21 |
2020 July | Vargas-Reverón et al. [47] | Journal of Arthroplasty | Prevalence and Impact of Positive Intraoperative Cultures in Partial Hip or Knee Revision | Retrospective, Single Center | THA TKA | 3 | 19 |
2021 June | Hipfl et al. [35] | The Bone and Joint Journal | Unexpected low-grade infections in revision hip arthroplasty for aseptic loosening: a single-institution experience of 274 hips | Retrospective, Single Center | THA | 3 | 17 |
2021 August | Neufeld et al. [25] | The Journal of Bone and Joint Surgery | Prevalence and Outcomes of Unexpected Positive Intraoperative Cultures in Presumed Aseptic Revision Hip Arthroplasty | Retrospective, Single Center | THA | 3 | 19 |
2022 May | Neufeld et al. [48] | Journal of Arthroplasty | The Prevalence and Outcomes of Unexpected Positive Intraoperative Cultures in Presumed Aseptic Revision Knee Arthroplasty | Retrospective, Single Center | TKA | 3 | 20 |
2022 June | Schwarze et al. [24] | Journal of Arthroplasty | Unsuspected Positive Cultures in Planned Aseptic Revision Knee or Hip Arthroplasty-Risk Factors and Impact on Survivorship | Retrospective, Single Center | THA TKA | 3 | 20 |
Minimum Follow-Up in Months | Follow-Up in Months (Range) | Samples n | Type of Samples | |
---|---|---|---|---|
Barrack [33] | 24 | 45 (24–74) 1 | min. 2 | synovial fluid, tissue |
Milandt [44] | 12 | n/a * | 3–5 | tissue |
Vargas-Reverón [47] | 60 | n/a * | 3–6 | synovial fluid, tissue |
Hipfl [35] | 24 | 68 (26–95) 1 | min. 3 | synovial fluid, tissue, sonication |
Neufeld [25] | 12 | 40 (18–77) 2 | 3–5 | swabs, synovial fluid, tissue |
Neufeld [48] | 12 | 43 (24–74) 2 | 3–5 | swabs, synovial fluid, tissue |
Schwarze [24] | 24 | 41 (25–31) 2 | 3–5 | tissue |
Author | Preoperative Algorithm |
---|---|
Barrack [33] | In all cases: Clinical examination, plain radiographs, serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) Preoperative synovial fluid aspiration in 1 of 3 centers routinely and in 2 of 3 selectively |
Milandt [44] | n/a * |
Vargas-Reverón [47] | In all cases: Clinical examination, plain radiographs, serum CRP, ESR, bone scintigraphy If suspicious: synovial fluid aspiration |
Hipfl [35] | In all cases: Clinical examination, plain radiographs, serum CRP If suspicious: synovial fluid aspiration |
Neufeld [25] | In all cases: Clinical examination, plain radiographs, serum CRP, ESR If suspicious: synovial fluid aspiration |
Neufeld [48] | In all cases: Clinical examination, plain radiographs, serum CRP, ESR If suspicious: synovial fluid aspiration |
Schwarze [24] | In all cases: Clinical examination, plain radiographs, serum C-reactive protein (CRP), synovial fluid aspiration |
Included Cases n | UPC Total n (% of All Cases) | Single UPC n (% of All UPCs) | Most Frequent Isolated Pathogen (%) | |
---|---|---|---|---|
Barrack [33] | 692 | 41 (6) | 29 (71) | ConS (49) |
Milandt [44] | 2305 | 282 (12) | 170 (60) | ConS (67) |
Vargas-Reverón [47] | 145 | 48 (32) | 35 (73) | ConS (96) |
Hipfl [35] | 274 | 77 (28) | 41 (53) | ConS (42) |
Neufeld [25] | 1196 | 110 (9) | 74 (68) * | C. acnes (38) |
Neufeld [48] | 775 | 76 (10) | 62 (82) | C. acnes (32) |
Schwarze [24] | 434 | 160 (37) | 119 (74) | ConS (43) |
Total | 5821 | 794 (14) | 530 (67) |
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Schwarze, J.; Moellenbeck, B.; Gosheger, G.; Puetzler, J.; Deventer, N.; Kalisch, T.; Schneider, K.N.; Klingebiel, S.; Theil, C. The Role of Single Positive Cultures in Presumed Aseptic Total Hip and Knee Revision Surgery—A Systematic Review of the Literature. Diagnostics 2023, 13, 1655. https://doi.org/10.3390/diagnostics13091655
Schwarze J, Moellenbeck B, Gosheger G, Puetzler J, Deventer N, Kalisch T, Schneider KN, Klingebiel S, Theil C. The Role of Single Positive Cultures in Presumed Aseptic Total Hip and Knee Revision Surgery—A Systematic Review of the Literature. Diagnostics. 2023; 13(9):1655. https://doi.org/10.3390/diagnostics13091655
Chicago/Turabian StyleSchwarze, Jan, Burkhard Moellenbeck, Georg Gosheger, Jan Puetzler, Niklas Deventer, Tobias Kalisch, Kristian Nikolaus Schneider, Sebastian Klingebiel, and Christoph Theil. 2023. "The Role of Single Positive Cultures in Presumed Aseptic Total Hip and Knee Revision Surgery—A Systematic Review of the Literature" Diagnostics 13, no. 9: 1655. https://doi.org/10.3390/diagnostics13091655