Bone and Joint Infectious Diseases Unit, Department of Orthopaedics and Trauma Surgery, Hospital Clinic of Barcelona, University of Barcelona, C/Villarroel 170, 08036, Barcelona, Spain,
Arch Orthop Trauma Surg. 2014 Apr;134(4):577-83. doi: 10.1007/s00402-014-1921-z. Epub 2014 Jan 14.
Bacterial identification is essential to diagnose and treat a revision for prosthetic loosening of an infected hip. The purpose of this study was to determine whether conventional cultures from the periprosthetic membrane are superior to synovial/pseudocapsule samples in the diagnosis of infection in hip revision arthroplasty.
We performed a prospective study including all hip revisions from October 2009 to October of 2011. Once the implants were removed and prior to the administration of the antibiotic prophylaxis, six periprosthetic samples from different sites were sent to the laboratory for culturing: two periprosthetic fluid samples, two solid material (synovial/pseudocapsule) samples and two swabs. Once the six samples were taken, antibiotic prophylaxis was administered and just as the implant was removed, two more solid samples of the periprosthetic membrane were obtained.
Of a total of 86 hip revision surgeries, 22 were considered septic revisions postoperatively, of which 16 resulted in positive cultures. Of these 16 revisions, 14 obtained the same microbiologic diagnostic when considering either the synovial/pseudocapsule culture results or the solid membrane sample.
We conclude that the membrane sample for a conventional culture is not superior to the synovial/pseudocapsule sample in detecting microorganisms.
细菌鉴定对于诊断和治疗感染性髋关节假体松动的翻修至关重要。本研究的目的是确定在髋关节翻修术中，假体周围膜的常规培养是否优于滑膜/假囊样本，以诊断感染。
我们进行了一项前瞻性研究，纳入了 2009 年 10 月至 2011 年 10 月期间所有的髋关节翻修手术。一旦取出植入物并在给予抗生素预防之前，从不同部位采集 6 份假体周围样本进行培养：2 份假体周围液样本、2 份固体材料（滑膜/假囊）样本和 2 份拭子。采集完 6 份样本后，给予抗生素预防，并在取出植入物的同时，再从假体周围膜获得 2 份固体样本。
在总共 86 例髋关节翻修手术中，22 例术后被认为是感染性翻修，其中 16 例培养结果阳性。在这 16 例翻修中，考虑滑膜/假囊培养结果或固体膜样本时，有 14 例获得了相同的微生物学诊断。
我们得出结论，常规培养的膜样本在检测微生物方面并不优于滑膜/假囊样本。
