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Unexpected positive cultures in revision total knee arthroplasty after unicompartmental knee arthroplasty

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Abstract

Purpose

Unexpected positive cultures are defined as a single positive culture in intraoperative samples taken during revision surgery after prosthetic joint infection was preoperatively ruled out. This study aims to determine the prevalence of unexpected positive cultures (UPC) in revision total knee arthroplasty (TKA) after unicompartmental knee arthroplasty (UKA). As a secondary objective, this study aims to compare the re-intervention rate in this specific group, between UPC and non-UPC patients. The hypothesis is that the UPC prevalence in patients who undergo a revision TKA after UKA is not higher than in other TKA revision cases and this does not increase the risk of re-intervention.

Methods

This is a retrospective study where all patients who underwent a UKA revision from January 2016 to February 2023 in a high-volume arthroplasty centre, were analyzed. Unexpected positive culture prevalence in this group of patients was obtained.

Results

During the included period, 270 UKA revision surgeries were performed. Eight cases had at least two positive cultures and were therefore excluded. The final analysis included 262 patients. Of these, 8 (3.05%) patients presented UPCs and the isolated microorganisms were low-virulence organisms. None of the UPC patients received any treatment. No statistical differences were found between UPC and non-UPC groups in the analyzed variables.

Conclusion

The prevalence of unexpected positive cultures in patients following revision of unicompartmental knee arthroplasty is lower than in patients who undergo a revision of total knee arthroplasty. In UKA patients a UPC does not seem to increase the risk of a re-intervention, so it can be safely ignored if ICM criteria are not met.

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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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Funding

The authors didn’t receive any financial support.

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Authors and Affiliations

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

    Yuri Lara-Taranchenko, Tiago Moreira, Abdullah A. Alfaraj, Thorsten Gehrke & Mustafa Citak

  2. 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

  3. Hospital Ortopedico de Goiânia, Goiânia, Brazil

    Tiago Moreira

  4. Al Razi Hospital, Kuwait, Kuwait

    Abdullah A. Alfaraj

  5. Joint Reconstruction Unit, Southland Hospital, Invercargill, New Zealand

    N. Amir Sandiford

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  1. Yuri Lara-Taranchenko
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  2. Tiago Moreira
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  3. Abdullah A. Alfaraj
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  4. N. Amir Sandiford
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  6. Thorsten Gehrke
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  7. Mustafa Citak
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All persons who meet authorship criteria are listed as authors, and all authors certify that they have participated sufficiently in the work.

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Correspondence to Mustafa Citak.

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Lara-Taranchenko, Y., Moreira, T., Alfaraj, A.A. et al. Unexpected positive cultures in revision total knee arthroplasty after unicompartmental knee arthroplasty. International Orthopaedics (SICOT) (2024). https://doi.org/10.1007/s00264-024-06203-7

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  • DOI: https://doi.org/10.1007/s00264-024-06203-7

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