Mm. Tunney et al., IMPROVED DETECTION OF INFECTION IN HIP REPLACEMENTS - A CURRENTLY UNDERESTIMATED PROBLEM, Journal of bone and joint surgery. British volume, 80B(4), 1998, pp. 568-572
Our aim was to determine if the detection rate of infection of total h
ip replacements could be improved by examining the removed prostheses,
Immediate transfer of prostheses to an anaerobic atmosphere, followed
by mild ultrasonication to dislodge adherent bacteria, resulted in th
e culture of quantifiable numbers of bacteria, from 26 of the 120 impl
ants examined, The same bacterial species were cultured by routine mic
robiological techniques from only fire corresponding tissue samples. T
issue removed from 18 of the culture-positive implants was suitable fo
r quantitative tissue pathology and inflammatory cells were present in
all samples. Furthermore, inflammatory cells were present in 87% of t
issue samples taken from patients whose implants were culture-negative
. This suggests that these implants may have been infected by bacteria
which were not isolated by the techniques of culture used. The increa
sed detection of bacteria from prostheses by culture has improved post
operative antibiotic therapy and should reduce the need for further re
vision.