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http://hdl.handle.net/2445/206250
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DC Field | Value | Language |
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dc.contributor.author | Vargas Reverón, Caribay | - |
dc.contributor.author | Font Vizcarra, Lluís | - |
dc.contributor.author | Morata, Laura | - |
dc.contributor.author | Fernández Valencia, Jenaro A. | - |
dc.contributor.author | Soriano, Alex | - |
dc.contributor.author | Muñoz Mahamud, Ernesto | - |
dc.date.accessioned | 2024-01-24T13:07:36Z | - |
dc.date.available | 2024-04-30T05:10:13Z | - |
dc.date.issued | 2023-04 | - |
dc.identifier.issn | 1528-1132 | - |
dc.identifier.uri | http://hdl.handle.net/2445/206250 | - |
dc.description.abstract | BackgroundThere can be unexpectedly positive culture results during elective hip arthroplasty, but the degree to which these are associated with an increased risk of subsequent premature revision is not known.Question/purposeAre unexpectedly positive culture results obtained during elective THA associated with an increased likelihood of revision within 5 years of the procedure?MethodsBetween March 2007 and March 2011, the hip unit at our institution performed elective primary THA in 829 patients. We systematically collected three samples in 52% (428 of 829) of the interventions. Of those, 26 patients were excluded because of sampling errors; 94% (402 of 428) had samples that were collected systematically and were eligible for the study. We only considered one hip randomly in bilateral procedures (4% [15 of 428]); patients presenting with acute (< 3 months) periprosthetic joint infection undergoing open debridement (4% [16 of 402]) and patients who died before 5 years of follow-up (2% [seven of 402]) were excluded from the study, leaving 91% (364 of 402) eligible for analysis in this retrospective study of a previous prospective trial. No patient included in the final analysis was lost to follow-up within 5 years from the index surgery. The patient group consisted of 52% (188 of 364) women, with a mean ± SD age of 64.8 ± 13.9 years.ResultsPositives culture results were associated with a higher risk of revision within 5 years of the index surgery. The proportion of revision surgery was higher in the group with positive culture results than in those with negative results (10% [eight of 77] versus 2% [seven of 290]; p = 0.01). The difference was mainly attributable to a higher proportion of aseptic loosening in those with positive culture results than in those with negative results (8% [six of 74] versus 1% [four of 290]; p = 0.01). After a multivariable analysis, the only independent variable associated with 5-year revision surgery was the presence of positive results during THA (odds ratio 4.9 [95% confidence interval 1.72 to 13.99]).ConclusionOur findings suggest that bacterial contamination during THA is associated with an increased likelihood of early revision. This higher risk of revision is mainly because of presumed aseptic loosening; thus, efforts should focus on the need to rule out infection. These results not only open new questions that should be answered in new prospective and well-designed studies, but also may help to better select patients to obtain a more favorable outcome after THA.Level of EvidenceLevel III, therapeutic study. Copyright © 2022 by the Association of Bone and Joint Surgeons. Unauthorized reproduction of this article is prohibited. | ca |
dc.format.extent | 20 p. | - |
dc.format.mimetype | application/pdf | - |
dc.language.iso | eng | ca |
dc.publisher | Wolters Kluwer Health Inc | ca |
dc.relation.isformatof | Versió postprint del document publicat a: https://doi.org/10.1097/CORR.0000000000002460 | - |
dc.relation.ispartof | Clinical Orthopaedics And Related Research, 2023, vol. 481, num. 4, p. 778-785 | - |
dc.relation.uri | https://doi.org/10.1097/CORR.0000000000002460 | - |
dc.rights | (c) Wolters Kluwer, 2023 | - |
dc.source | Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer) | - |
dc.subject.classification | Pròtesis | - |
dc.subject.classification | Artroplàstia | - |
dc.subject.other | Prosthesis | - |
dc.subject.other | Arthroplasty | - |
dc.title | Do Cultures Obtained During Primary THA Predict the Likelihood of Revision? | ca |
dc.type | info:eu-repo/semantics/article | ca |
dc.type | info:eu-repo/semantics/acceptedVersion | - |
dc.date.updated | 2024-01-22T11:39:19Z | - |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | - |
dc.identifier.idimarina | 9349967 | - |
dc.identifier.pmid | 36278949 | - |
Appears in Collections: | Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer) |
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renamed_merged.pdf | 443.25 kB | Adobe PDF | View/Open |
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