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Unexpected positive cultures in patients with arthrofibrosis following total hip and total knee arthroplasty

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Abstract

Purpose

It has been suggested that low-grade infections could be the cause of arthrofibrosis. However, this hypothesis has not been conclusively proven. The aim of this study is to assess the incidence of unexpected positive cultures (UPC) in patients undergoing revision total joint arthroplasty for a diagnosis of arthrofibrosis.

Methods

A retrospective single-centre review was performed. All patients who underwent an aseptic revision due to histologically confirmed arthrofibrosis (based on the synovial-like interface membrane (SLIM) criteria) were included. The incidence of UPC was then calculated.

Results

A total of 147 patients were included. Of these, 100 underwent a total knee arthroplasty (TKA) procedure and 46 a total hip arthroplasty (THA) surgery. One patient had a periprosthetic joint infection and was therefore excluded. Of the 146 included patients, 6 had confirmed UPC (4.08%). The following bacteria were identified: Anaerococcus octavius, Staphylococcus epidermidis, Enterobacter cloacae, Staphylococcus hominis, Streptococcus pluranimalium, Staphylococcus pettenkoferi.

Conclusions

Our results suggest that the incidence of UPC in patients with arthrofibrosis is low. It is lower than that of UPC in patients that undergo a revision for other causes. There is no proven relationship between histologically confirmed arthrofibrosis following total joint arthroplasty and prosthetic joint infection.

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Data availability

The authors have the database available in Microsoft Excel and SPSS formats, and we are disposed to send it if it is required.

Code availability

All statistical analysis were performed using IBM SPSS Statistics (version 24.0; New 103 York, NY, USA).

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Authors and Affiliations

  1. Orthopaedic Surgery Department, Vall d’Hebron University Hospital, Universitat Autonoma de Barcelona, Pg. Vall d’Hebron 119-129, 08035, Barcelona, Spain

    Yuri Lara-Taranchenko & Ernesto Guerra-Farfán

  2. Helios ENDO-Klinik, Holstenstraße 2, 22767, Hamburg, Germany

    Yuri Lara-Taranchenko, Tiago Moreira, Thorsten Gehrke & Mustafa Citak

  3. Hospital Ortopedico de Goiânia, Goiania, Brazil

    Tiago Moreira

  4. Joint Reconstruction Unit, Southland Hospital, Kew Road, Kew, Invercargill, 9812, New Zealand

    N. Amir Sandiford

Authors
  1. Yuri Lara-Taranchenko
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  2. Tiago Moreira
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  3. N. Amir Sandiford
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  4. Ernesto Guerra-Farfán
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  5. Thorsten Gehrke
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  6. Mustafa Citak
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Correspondence to Mustafa Citak.

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Lara-Taranchenko, Y., Moreira, T., Sandiford, N.A. et al. Unexpected positive cultures in patients with arthrofibrosis following total hip and total knee arthroplasty. International Orthopaedics (SICOT) 48, 345–350 (2024). https://doi.org/10.1007/s00264-023-05990-9

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