The Prevalence and Outcomes of Unexpected Positive Intraoperative Cultures in Presumed Aseptic Revision Hip Arthroplasty

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This presentation by Michael Neufeld discusses a study focused on the increasing prevalence of unexpected positive cultures during revision total hip replacements, despite the lack of a perfect diagnostic test for prosthetic joint infection. Conducted at the University of London, Ontario, the retrospective study analyzed data from 1,196 aseptic revisions performed between 2006 and 2019, of which 110 patients had unexpected positive cultures. Key findings include a prevalence rate of 9.2% for unexpected cultures and infection-free survival rates of approximately 93% at two years and 87% at five years for the entire cohort. The study also identified that patients with a single unexpected culture not treated with antibiotics had no subsequent infections. Factors such as adverse metal reaction were significantly associated with infection-related failures, indicating the need for cautious interpretation of the data due to study limitations. The results suggest that in cases of unexpected positive cultures without other infection signs, antibiotic treatment may not be necessary.

DOI: 10.1302/3114-220890

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