Clinical and microbiological findings in prosthetic joint replacement due to aseptic loosening

Summary Objectives A role for microorganisms in aseptic prosthetic loosening (AL) is postulated. We analyse the microbiological and clinical findings of patients with suspected AL, and compare them with patients with chronic prosthetic joint infection (PJI). Methods Prospective study (2011–2012) of...

Full description

Saved in:

Bibliographic Details
Published in:	The Journal of infection Vol. 69; no. 3; pp. 235 - 243
Main Authors:	Ribera, A, Morata, L, Moranas, J, Agulló, J.L, Martínez, J.C, López, Y, García, D, Cabo, J, García-Ramiro, S, Soriano, A, Murillo, O
Format:	Journal Article
Language:	English
Published:	Amsterdam Elsevier Ltd 01-09-2014 Elsevier
Subjects:	Aged Aged, 80 and over Arthroplasty, Replacement, Hip Arthroplasty, Replacement, Knee Aseptic loosening Biological and medical sciences Bone and Bones - microbiology Equipment Failure Analysis Female General aspects Hip Joint - microbiology Hip Prosthesis - adverse effects Hip Prosthesis - microbiology Humans Infectious Disease Knee Joint - microbiology Knee Prosthesis - adverse effects Knee Prosthesis - microbiology Male Medical sciences Microorganisms Prospective Studies Prosthesis Failure - etiology Prosthesis-Related Infections - complications Prosthesis-Related Infections - diagnosis Prosthesis-Related Infections - microbiology Prosthetic joint Reoperation Sonication Synovial Membrane - microbiology Time Factors Prosthetic joint Aseptic loosening Microorganisms Infection Symptomatology Prosthesis
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Summary Objectives A role for microorganisms in aseptic prosthetic loosening (AL) is postulated. We analyse the microbiological and clinical findings of patients with suspected AL, and compare them with patients with chronic prosthetic joint infection (PJI). Methods Prospective study (2011–2012) of patients with presumed AL. Evaluation of tissue samples (≥5; TS) at the time of surgery and sonication fluid (SF) of prosthesis. Results According to positive culture in TS/SF, 89 patients were divided into: Group 1 : (≥2 positive-TS; n = 12); Group 2 : single positive-TS and concordant SF ( n = 10); Group 3 : one positive or non-concordant TS or SF ( n = 38); and Group 4 : cultures negative ( n = 29). Positive-SF was always concordant with TS in Group 1 (75%); it was positive in 74% in Group 3. Median months (prosthesis-age: implantation to revision arthroplasty) for PJI and Group 1–4 was 21, 46, 65, 63 and 81, respectively ( P < 0.001); they also had a different dynamic trend in prosthesis failure ( P < 0.001). Conclusions Several patients with suspected AL are misdiagnosed PJI. Results from SF correlated well with TS in Group 1, led us to consider single positive-TS as significant (Group 2) and to suggest that microorganisms were on the prosthesis (Group 3). We observed a correlation between microbiology and prosthesis-age, which supports that early loosening is more often caused by hidden PJI than late loosening.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0163-4453 1532-2742
DOI:	10.1016/j.jinf.2014.05.003