Despite a preoperative workup with no evidence to suspect a prosthetic joint infection (PJI) before revision surgery, routinely obtained intraoperative cultures still can be unexpectedly positive. The purpose of this study was (1) to assess the incidence of unexpected positive intraoperative cultures in presumed aseptic knee and hip revisions and (2) to determine whether a difference exists between the infection-free implant survival rate of patients with and without unexpected positive intraoperative cultures. We selected patients who underwent a one-stage revision total knee arthroplasty (TKA) or total hip arthroplasty (THA) for different reasons. Three or more separate intraoperative cultures were obtained during each procedure. A negative result was defined as less than two positive cultures with the same microorganism. An unsuspected PJI was defined as having two or more positive cultures with the same microorganism. Patients’ medical records were reviewed to collect demographics, preoperative laboratory results, culture results, and the occurrence of infection during follow-up.Aim
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