Multiple cultures and extended incubation for hip and knee arthroplasty revision: Impact on clinical care

Alexander DeHaan, Thomas Huff, Kathryn Schabel, Yee-Cheen Doung, James Hayden, Penelope Barnes

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

The impact on patient care of introducing a protocol of obtaining 5 or more intra-operative separate tissue biopsies that were cultured for 10. days was assessed for hip and knee arthroplasty revision. The charts of seventy-three patients undergoing 77 cases of revision arthroplasty were reviewed one year post-operatively. When compared to the prior standard of obtaining only one intra-operative culture, the protocol changed the microbiological diagnosis in 26/77 cases (34%, 95% Confidence Interval (CI): 23-45%) and antibiotic treatment in 23/77 cases (30%, 95% CI: 20-41%). In addition, the protocol had a predictive value of joint sterility in culture negative cases of 95% (95% CI: 85-99%). This data demonstrated the new protocol significantly changed patient care, and suggests that 1 or 2 cultures are insufficient. Adopting a similar protocol should be considered by surgeons and institutions as a new minimum standard for management of prosthetic joint infections.

Original languageEnglish (US)
Pages (from-to)59-65
Number of pages7
JournalJournal of Arthroplasty
Volume28
Issue number8 SUPPL
DOIs
StatePublished - Sep 2013

Fingerprint

Knee Replacement Arthroplasties
Hip
Confidence Intervals
Patient Care
Joints
Arthroplasty
Infertility
Anti-Bacterial Agents
Biopsy
Infection
Therapeutics

Keywords

  • Hip arthroplasty
  • Infection
  • Knee arthroplasty
  • Multiple cultures
  • Revision arthroplasty

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Multiple cultures and extended incubation for hip and knee arthroplasty revision : Impact on clinical care. / DeHaan, Alexander; Huff, Thomas; Schabel, Kathryn; Doung, Yee-Cheen; Hayden, James; Barnes, Penelope.

In: Journal of Arthroplasty, Vol. 28, No. 8 SUPPL, 09.2013, p. 59-65.

Research output: Contribution to journalArticle

@article{26e9feacfb4345dc93007214be4ae4d3,
title = "Multiple cultures and extended incubation for hip and knee arthroplasty revision: Impact on clinical care",
abstract = "The impact on patient care of introducing a protocol of obtaining 5 or more intra-operative separate tissue biopsies that were cultured for 10. days was assessed for hip and knee arthroplasty revision. The charts of seventy-three patients undergoing 77 cases of revision arthroplasty were reviewed one year post-operatively. When compared to the prior standard of obtaining only one intra-operative culture, the protocol changed the microbiological diagnosis in 26/77 cases (34{\%}, 95{\%} Confidence Interval (CI): 23-45{\%}) and antibiotic treatment in 23/77 cases (30{\%}, 95{\%} CI: 20-41{\%}). In addition, the protocol had a predictive value of joint sterility in culture negative cases of 95{\%} (95{\%} CI: 85-99{\%}). This data demonstrated the new protocol significantly changed patient care, and suggests that 1 or 2 cultures are insufficient. Adopting a similar protocol should be considered by surgeons and institutions as a new minimum standard for management of prosthetic joint infections.",
keywords = "Hip arthroplasty, Infection, Knee arthroplasty, Multiple cultures, Revision arthroplasty",
author = "Alexander DeHaan and Thomas Huff and Kathryn Schabel and Yee-Cheen Doung and James Hayden and Penelope Barnes",
year = "2013",
month = "9",
doi = "10.1016/j.arth.2013.03.037",
language = "English (US)",
volume = "28",
pages = "59--65",
journal = "Journal of Arthroplasty",
issn = "0883-5403",
publisher = "Churchill Livingstone",
number = "8 SUPPL",

}

TY - JOUR

T1 - Multiple cultures and extended incubation for hip and knee arthroplasty revision

T2 - Impact on clinical care

AU - DeHaan, Alexander

AU - Huff, Thomas

AU - Schabel, Kathryn

AU - Doung, Yee-Cheen

AU - Hayden, James

AU - Barnes, Penelope

PY - 2013/9

Y1 - 2013/9

N2 - The impact on patient care of introducing a protocol of obtaining 5 or more intra-operative separate tissue biopsies that were cultured for 10. days was assessed for hip and knee arthroplasty revision. The charts of seventy-three patients undergoing 77 cases of revision arthroplasty were reviewed one year post-operatively. When compared to the prior standard of obtaining only one intra-operative culture, the protocol changed the microbiological diagnosis in 26/77 cases (34%, 95% Confidence Interval (CI): 23-45%) and antibiotic treatment in 23/77 cases (30%, 95% CI: 20-41%). In addition, the protocol had a predictive value of joint sterility in culture negative cases of 95% (95% CI: 85-99%). This data demonstrated the new protocol significantly changed patient care, and suggests that 1 or 2 cultures are insufficient. Adopting a similar protocol should be considered by surgeons and institutions as a new minimum standard for management of prosthetic joint infections.

AB - The impact on patient care of introducing a protocol of obtaining 5 or more intra-operative separate tissue biopsies that were cultured for 10. days was assessed for hip and knee arthroplasty revision. The charts of seventy-three patients undergoing 77 cases of revision arthroplasty were reviewed one year post-operatively. When compared to the prior standard of obtaining only one intra-operative culture, the protocol changed the microbiological diagnosis in 26/77 cases (34%, 95% Confidence Interval (CI): 23-45%) and antibiotic treatment in 23/77 cases (30%, 95% CI: 20-41%). In addition, the protocol had a predictive value of joint sterility in culture negative cases of 95% (95% CI: 85-99%). This data demonstrated the new protocol significantly changed patient care, and suggests that 1 or 2 cultures are insufficient. Adopting a similar protocol should be considered by surgeons and institutions as a new minimum standard for management of prosthetic joint infections.

KW - Hip arthroplasty

KW - Infection

KW - Knee arthroplasty

KW - Multiple cultures

KW - Revision arthroplasty

UR - http://www.scopus.com/inward/record.url?scp=84884162983&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84884162983&partnerID=8YFLogxK

U2 - 10.1016/j.arth.2013.03.037

DO - 10.1016/j.arth.2013.03.037

M3 - Article

C2 - 23886405

AN - SCOPUS:84884162983

VL - 28

SP - 59

EP - 65

JO - Journal of Arthroplasty

JF - Journal of Arthroplasty

SN - 0883-5403

IS - 8 SUPPL

ER -