The effectiveness of mandatory joint aspiration prior to re-implantation in patients with a cement spacer already in place is unclear. The aim of this study was to evaluate the role of culturing articular fluid obtained by joint aspiration prior to re-implantation in patients who underwent a two stage septic revision. A retrospective observational study was conducted, assessing51 patients that underwent a two stage septic hip or knee revision from 2010 to 2017. According to the results of intraoperative cultures, after the first stage revision each patient was treated with an antibiotic protocol for 6–8 weeks. Following two weeks without antibiotics, a culture of synovial fluid was obtained. Synovial fluid was obtained by direct joint aspiration in cases of knee spacers by and by joint aspiration guided by fluoroscopy in the theatre room in cases of hip spacers. Synovial fluid was transferred into a Vacutainer ACD® flask. Samples were processed and analysed in the microbiology laboratory. Gram stains were performed and the sample was subsequently transferred into a BacALERT bottle (bioMérieux, France) and incubated in a BacALERT instrument for seven days. Results of these cultures were recorded and compared with cultures obtained during re-implantation surgery.Aim
Method
In two-stage replacements for septic loosening, some studies have suggested that associate bacterial colonization of spacers had a worse result in relation to the control of the infection and a higher rate of complications after the implantation of the definitive prosthesis. The aim of our study was to determine the reoperation rate of patients undergoing two-stage revision surgery according to the results of spacer sonication. A retrospective observational study was conducted in which 56 hip or knee spacers implanted at our center from 2010 to 2017 were analysed. Patients were grouped into three categories: Patients with positive spacer sonication fluid culture, with or without positive cultures from the rest of the samples. Patients with negative spacer sonication culture and negative second-stage intraoperative cultures. Patients with negative spacer sonication culture but positive cultures of the rest of intraoperative samples.Aim
Method
