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Hip aspiration culture: analysing data from a single operator series investigating periprosthetic joint infection

Lookup NU author(s): Dr Sam Tingle

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).

Abstract

© 2021 Connor J. Barker et al.Introduction: We undertook this study to know the sensitivity, specificity and post-test probabilities of hip aspiration when diagnosing periprosthetic hip infections. We also examined "dry tap"(injection with saline and aspiration) results and aspiration volumes. Methods: This is a retrospective cohort study of patients aspirated for suspected periprosthetic joint infection between July 2012 and October 2016. All aspirations were carried out by one trained surgical care practitioner (SCP). All aspirations followed an aseptic technique and fluoroscopic guidance. Aspiration was compared to tissue biopsy taken at revision. Aspiration volumes were analysed for comparison. Results: Between January 2012 and September 2016, 461 hip aspirations were performed by our SCP. Of these 125 progressed to revision. We calculated sensitivity 59 % (confidence interval (CI) 35 %-82 %) and specificity 94 % (CI 89 %-98 %). Pre-test probability for our cohort was 0.14. Positive post-test probability was 0.59 and negative post-test probability 0.06. Aspiration volume for infected (n=17) and non-infected (n=108) joints was compared and showed no significant difference. Dry taps were experienced five times; in each instance the dry tap agreed with the biopsy result. Conclusions: Our data show that hip aspiration culture is a highly specific investigation for diagnosing infection but that it is not sensitive. Aspiration volume showed no significant difference between infected and non-infected groups. Each time a joint was infiltrated with saline to achieve a result, the result matched tissue sampling. Copyright:

Publication metadata

Author(s): Barker CJ, Marriot A, Khan M, Oswald T, Tingle SJ, Partington PF, Carluke I, Reed MR

Publication type: Article

Publication status: Published

Journal: Journal of Bone and Joint Infection

Year: 2021

Volume: 6

Issue: 6

Pages: 165-170

Online publication date: 10/05/2021

Acceptance date: 09/04/2021

Date deposited: 07/11/2023

ISSN (electronic): 2206-3552

Publisher: Copernicus GmbH

URL: https://doi.org/10.5194/jbji-6-165-2021

DOI: 10.5194/jbji-6-165-2021

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