Orthopaedic surgery
Postoperative Antibiotic Duration and Treatment Failure After Aseptic Revision Arthroplasty With a Single Unexpected Positive Culture: A Retrospective Cohort Study
By Hsieh HC, Kuo FC, Hsu AHS and 3 others.
Abstract
Objectives
The clinical significance of a single unexpected positive intraoperative culture (UPC) during aseptic revision arthroplasty remains unclear. This study primarily aimed to evaluate the association between postoperative antibiotic duration and treatment failure in patients with a single UPC after aseptic revision total hip or knee arthroplasty. A secondary aim was to compare failure-free survival between patients with a single UPC and those with multiple UPCs.
Methods
We retrospectively reviewed 51 presumed aseptic revision hip or knee arthroplasties with UPCs performed between January 1999 and December 2023. Cases meeting the 2018 ICM criteria for periprosthetic joint infection were excluded. Postoperative antibiotic duration was the exposure of interest. Treatment failure, defined as infection-related re-revision, was the primary outcome; failure-free survival was the secondary outcome. Continuous variables were compared using the Mann-Whitney U test, and categorical variables were compared using chi-square or Fisher's exact tests. Factors associated with failure were examined using univariate logistic regression, and failure-free survival was assessed using Kaplan-Meier analysis with the log-rank test.