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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Role of joint aspiration before re-implantation in patients with a cement spacer in place
Sandra Huguet, Martí Bernaus, Lucía Gómez, Eva Cuchí, Alex Soriano, Lluís Font-Vizcarra
Sandra Huguet, Department of Traumatology and Orthopaedics, Hospital Universitari Mútua Terrassa, Terrassa 08221, Spain
Sandra Huguet, Department of Traumatology and Orthopaedics, Consorci Sanitari de l’Alt Penedès - Garraf, Vilafranca del Penedès 08720, Spain
Martí Bernaus, Lluís Font-Vizcarra, Department of Traumatology and Orthopaedics, Osteoarticular Infections Unit, Hospital Universitari Mútua Terrassa, Terrassa 08221, Spain
Lucía Gómez, Eva Cuchí, Osteoarticular Infections Unit, Hospital Universitari Mútua Terrassa, Terrassa 08221, Spain
Eva Cuchí, Department of Microbiology, CATLAB, Viladecavalls 08232, Spain
Alex Soriano, Department of Infectious Diseases, Osteoarticular Infections Unit, Hospital Clínic, Barcelona 08036, Spain
Author contributions: Huguet S wrote this manuscript; Huguet S, Bernaus M, Gómez L, Cuchí E, Soriano A, and Font-Vizcarra L commented on previous versions of the manuscript; All authors read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Mútua Terrassa Institutional Review Board.
Informed consent statement: No written consent was needed for this article. No identifying information is included in this article.
Conflict-of-interest statement: No conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Sandra Huguet, MD, Surgeon, Department of Traumatology and Orthopaedics, Hospital Universitari Mútua Terrassa, Plaça del Doctor Robert, 5, Terrassa 08221, Spain. sahuguet@csap.cat
Received: December 27, 2021
Peer-review started: December 27, 2021
First decision: January 25, 2022
Revised: April 4, 2022
Accepted: May 13, 2022
Article in press: May 13, 2022
Published online: June 18, 2022
ARTICLE HIGHLIGHTS
Research background
There are few studies in the literature based on the usefulness of joint aspiration with a cement spacer in place. The importance of this type of study lies in finding useful methods for determining the appropriate timing of the second stage of revision surgery.
Research motivation
The main problem in this type of research is its heterogeneity, as the duration of antibiotic treatment, the presence of antibiotic holiday, the use or not of a physiological saline solution when a dry aspiration is obtained, etc vary according to each institution’s protocol.
Research objectives
The objective of this study was to evaluate the role of culturing synovial fluid obtained by joint aspiration before re-implantation in patients who underwent a two-stage septic revision.
Research methods
This is a retrospective study, and the research method was to observe the results obtained in the joint aspiration performed before re-implantation in the knee/hip septic replacements in our center between 2010 and 2017.
Research results
The results obtained in the study showed low sensitivity of joint aspiration for detecting infection persistence when performed prior to the second stage in a two-stage replacement.
Research conclusions
The results obtained in our study lead us to not recommend the use of joint aspiration prior to the second stage of revision surgery due to its low sensitivity.
Research perspectives
Future research should focus on obtaining reliable markers to indicate the optimal time to perform the second stage of a two-stage septic revision.
