Suardi Virginia, Logoluso Nicola, Anghilieri Filippo Maria, Santoro Giuseppe, Pellegrini Antonio Virgilio
Department of Reconstructive Surgery of Osteo-Articular Infections, IRCCS Istituto Ortopedico Galeazzi, 20100 Milan, Italy.
Resident in Orthopedia and Traumatology, University of Milan, 20100 Milan, Italy.
Antibiotics (Basel). 2022 Oct 13;11(10):1408. doi: 10.3390/antibiotics11101408.
Periprosthetic joint infection (PJI) is among the most feared orthopedic complications. Critical questions are whether the infection is completely resolved before reimplantation and what the clinical significance of positive culture is at reimplantation. The aim of this study was to determine whether a correlation exits between culture results at reimplantation after spacer insertion for hip and knee PJI and treatment failure rate. The data of 84 patients who underwent two-stage exchange arthroplasty for hip or knee PJI were reviewed and the results of intraoperative culture at reimplantation were analyzed quantitatively and qualitatively. Correlations were sought between these patterns and treatment outcome. Our data indicate no evidence for a correlation between positive culture at reimplantation and greater risk of treatment failure. Nonetheless, we noted a higher, albeit statistically not significant rate of treatment failure in patients with at least two samples testing positive. The role of microbiology at reimplantation remains unclear, but a positive culture might signal increased risk for subsequent implant failure. Further studies are needed to elucidate the implications of this finding.
人工关节周围感染（PJI）是最令人担忧的骨科并发症之一。关键问题在于在再次植入前感染是否已完全消除，以及再次植入时培养阳性的临床意义是什么。本研究的目的是确定在髋关节和膝关节PJI的间隔器插入后再次植入时的培养结果与治疗失败率之间是否存在相关性。回顾了84例行髋关节或膝关节PJI两阶段翻修置换术患者的数据，并对再次植入时的术中培养结果进行了定量和定性分析。探寻这些模式与治疗结果之间的相关性。我们的数据表明，没有证据显示再次植入时培养阳性与更高的治疗失败风险相关。尽管如此，我们注意到至少两个样本检测呈阳性的患者治疗失败率较高，尽管在统计学上不显著。再次植入时微生物学的作用仍不明确，但培养阳性可能预示着随后植入失败的风险增加。需要进一步研究以阐明这一发现的意义。
