138.
Clinical outcome for 223 patients after hip revision with positve
microbiological cultures
Predrag Kokanovic, Poul Torben Nielsen, Juozas Petruskevicius
Orthopedic surgery department Aalborg Hospital, University of Aarhus;
Orthopedic surgery department, Aalborg Hospital, University of Aarhus;
Orthopedic surgery department, Aalborg Hospital, University of Aarhus
Background:
Harvesting tissue ad modum Kamme & Lindberg for
microbiological analysis has become a standard procedure for patients who
undergo hip revision in Denmark. Bacterial identification plays a key role in
management of both patients with obvious hip infection and those in which
positive microbiological specimens are detected unexpectedly.
Purpose / Aim of Study:
Aim of study is to analyse the microbiological
profile of positive cultures detected during hip operation and evaluate the
impact of the infecting agent on clinical outcome.
Materials and Methods:
The positive microbiological specimens obtained
during hip surgery from 1995 to 2005 at Aalborg Hospital were analysed
retrospectively. We identified 223 patients (92 males and 131 female; mean
age 72 y.) with 266 positive Kamme biopsies. 203 patients had previous
surgery. We defined hips as infected if
≥
3
specimens in Kamme biopsy were
positive.
≤
2
positive results were regarded as probable contamination. The
outcome was defined when one of the following stationary conditions was
achieved: eradicated infection in hip with implant, chronic infection in hip
with implant, Girdlestone’s hip resection arthroplasty, exarticulation, death due
to infection or to other reasons, patient lost at follow-up.
Findings / Results:
Hip infection was revealed in 88% of patients. These
patients had worse outcome compared with those with probably contamination
-
infection eradicated in hip with implant: 61% vs 82%, Girdlestone’s hip
23.5%
vs 15%, chronic infection: 2.5% vs 0, dead 13% vs 4%. Staphylococcus
aureus was found in 36 % of all cultures.
Conclusions:
Our study confirms that
≥
3
positive specimens in Kamme
biopsy had prognostic value and the treatment course for these patients is
usually prolonged with a high failure rate.
