Diagnostic utility of open biopsy in patients with two culture-negative aspirations in the diagnostic work-up of periprosthetic joint infection

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dc.contributor.authorKlaber, Ianiv
dc.contributor.authorScholz, Fabian
dc.contributor.authorCitak, Mustafa
dc.contributor.authorZahar, Akos
dc.contributor.authorGehrke, Thorsten
dc.contributor.authorHaasper, Carl
dc.contributor.authorHawi, Nael
dc.contributor.authorLausmann, Christian
dc.date.accessioned2025-01-20T20:22:12Z
dc.date.available2025-01-20T20:22:12Z
dc.date.issued2023
dc.description.abstractIntroduction Different approaches have been proposed for bacterial identification in patients with a suspected periprosthetic joint infection (PJI). If a one-stage procedure is considered, a higher rate of preoperative bacterial identification can be achieved if biopsy is included in the diagnostic work-up. The performance of open biopsy (OB) in the context of PJI has not been clearly determined yet. The purpose of this study was to determine the value of an OB added to two consecutive culture-negative joint aspirations during PJI workup. Materials and methods We retrospectively analyzed the OB data from a single institution. Patients under PJI work-up of the hip or knee with two culture-negative periprosthetic aspirations who underwent OB were included. Sensitivity and specificity were calculated using the musculoskeletal infection society (MSIS) criteria as gold standard. Patients undergoing urgent irrigation and debridement and patients with history of surgery to the affected joint in the prior 6 weeks were excluded. Results 126 patients were included in this study. 62 (49.2%) patients had prior revisions, 48 of them due to PJI. The sensitivity and specificity of OB was 69.4% and 89.1%, respectively. The OB procedure led to the identification of the causative germ in 50 out of 126 (40%) cases so they could undergo one-stage (septic) exchange. Conclusion The OB is a valuable resource if preoperative synovial fluid cultures are negative, a high suspicion of infection persists and a one-stage procedure is preferred. It intends bacteria identification and allows surgeons to evaluate prosthetic complications for further surgical procedures.
dc.fuente.origenWOS
dc.identifier.doi10.1007/s00402-021-04142-1
dc.identifier.eissn1434-3916
dc.identifier.issn0936-8051
dc.identifier.urihttps://doi.org/10.1007/s00402-021-04142-1
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/92665
dc.identifier.wosidWOS:000693121600002
dc.issue.numero2
dc.language.isoen
dc.pagina.final754
dc.pagina.inicio749
dc.revistaArchives of orthopaedic and trauma surgery
dc.rightsacceso restringido
dc.subjectRevision arthroplasty
dc.subjectOpen biopsy
dc.subjectCulture negative
dc.subjectPeriprosthetic joint infection
dc.subjectJoint aspiration
dc.subjectSeptic exchange arthroplasty
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleDiagnostic utility of open biopsy in patients with two culture-negative aspirations in the diagnostic work-up of periprosthetic joint infection
dc.typeartículo
dc.volumen143
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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