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. 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.

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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

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