Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jun 18;13(6):615-621.
doi: 10.5312/wjo.v13.i6.615.

Role of joint aspiration before re-implantation in patients with a cement spacer in place

Sandra Huguet  1 , Martí Bernaus  2 , Lucía Gómez  3 , Eva Cuchí  3 , Alex Soriano  4 , Lluís Font-Vizcarra  2
Affiliations

Role of joint aspiration before re-implantation in patients with a cement spacer in place

Sandra Huguet et al. World J Orthop. .

Abstract

Background: The usefulness of a mandatory joint aspiration before re-implantation in patients with a cement spacer already in place is unclear.

Aim: To evaluate the role of culturing synovial fluid obtained by joint aspiration before re-implantation in patients who underwent a two-stage septic revision.

Methods: A retrospective observational study was conducted, including patients that underwent a two-stage septic revision (hip or knee) from 2010 to 2017. After the first stage revision and according to intraoperative culture results, all patients were treated with an antibiotic protocol for 6-8 wk. Following 2 wk without antibiotics, a culture of synovial fluid was obtained. The results of these cultures were recorded and compared with cultures obtained during re-implantation surgery.

Results: Forty-one patients (20 hip and 21 knee spacers) were included in the final analysis. In 39 cases, the culture of synovial fluid was negative, while in the remaining 2 cases (knee spacers) no analysis was possible due to dry tap. In 5 of the patients, two or more intraoperative cultures taken during the re-implantation surgery were positive.

Conclusion: We found no evidence to support mandatory joint aspiration before re-implantation in patients with a cement spacer in place.

Keywords: Joint aspiration; Periprosthetic joint infection; Revision surgery; Synovial fluid; Two-stage surgery.

PubMed Disclaimer

Conflict of interest statement

Conflict-of-interest statement: No conflict of interest.

Figures

Figure 1
Figure 1
Hip arthrocentesis procedure. A: Hip arthrocentesis setup; B: Hip arthrocentesis.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Anagnostakos K, Fürst O, Kelm J. Antibiotic-impregnated PMMA hip spacers: Current status. Acta Orthop. 2006;77:628–637. - PubMed
    1. Cui Q, Mihalko WM, Shields JS, Ries M, Saleh KJ. Antibiotic-impregnated cement spacers for the treatment of infection associated with total hip or knee arthroplasty. J Bone Joint Surg Am. 2007;89:871–882. - PubMed
    1. Kurd MF, Ghanem E, Steinbrecher J, Parvizi J. Two-stage exchange knee arthroplasty: does resistance of the infecting organism influence the outcome? Clin Orthop Relat Res. 2010;468:2060–2066. - PMC - PubMed
    1. Biring GS, Kostamo T, Garbuz DS, Masri BA, Duncan CP. Two-stage revision arthroplasty of the hip for infection using an interim articulated Prostalac hip spacer: a 10- to 15-year follow-up study. J Bone Joint Surg Br. 2009;91:1431–1437. - PubMed
    1. Trampuz A, Hanssen AD, Osmon DR, Mandrekar J, Steckelberg JM, Patel R. Synovial fluid leukocyte count and differential for the diagnosis of prosthetic knee infection. Am J Med. 2004;117:556–562. - PubMed