Polymerase Chain Reaction Can Detect Bacterial DNA in Aseptically Loose Total Hip Arthroplasties
- 1 October 2004
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Clinical Orthopaedics and Related Research
- Vol. 427 (427), 132-137
- https://doi.org/10.1097/01.blo.0000136839.90734.b7
Abstract
Identifying low-grade infection in failed total hip arthroplasties is an important but difficult task. This study investigated the ability of the polymerase chain reaction to identify low-grade infection during revision of total hip arthroplasties that failed from aseptic causes. One hundred thirteen specimens from 31 total hip arthroplasties revised for aseptic loosening were compared with 105 control specimens from 28 primary total hip arthroplasties. All surgeries were done in laminar flow operating rooms. No primary or revision specimen had positive microbiologic cultures. No revision specimen had histologic evidence suggestive of infection. Using the polymerase chain reaction with a detection threshold of 10 organisms per cubic centimeter of specimen, bacterial DNA was identified in 39 of 85 revision tissue specimens (46%) compared with 18 of 84 primary tissue specimens (21.4%). Bacterial DNA was identified in the synovial fluid of three specimens taken from 28 revision total hip arthroplasties (10.7%) and in two specimens taken from 21 primary total hip arthroplasties (9.5%). As multiple specimens were sent for each hip, a maximum of 16 of 31 revision total hip arthroplasties (52%) and eight of 28 primary total hip arthroplasties (29%) were considered to be infected. Bacterial DNA can be found in many specimens obtained from revised total hip arthroplasties considered to be aseptically loose. Because bacterial DNA identified at primary total hip arthroplasty was assumed to be attributable to contamination rather than present in healthy tissues, the overall specimen contamination rate of 19% and case contamination rate of 29% indicate that the polymerase chain reaction has poor specificity at this sensitivity level for diagnosing infection in revision total hip arthroplasty.Keywords
This publication has 10 references indexed in Scilit:
- Histological and microbiological findings in non-infected and infected revision arthroplasty tissuesArchives of orthopaedic and trauma surgery, 2000
- An assessment of the histological criteria used to diagnose infection in hip revision arthroplasty tissuesJournal of Clinical Pathology, 1999
- [42] Detection of prosthetic joint biofilm infection using immunological and molecular techniquesMethods in Enzymology, 1999
- Improved detection of infection in hip replacementsThe Journal of Bone and Joint Surgery. British volume, 1998
- Polymerase Chain Reaction Detection of Bacterial Infection in Total Knee ArthroplastyClinical Orthopaedics and Related Research, 1996
- Aspiration of the Hip Joint before Revision Total Hip Arthroplasty. Clinical and Laboratory Factors Influencing Attainment of a Positive Culture*The Journal of Bone & Joint Surgery, 1996
- The value of aspiration of the hip joint before revision total hip arthroplasty.The Journal of Bone & Joint Surgery, 1993
- The Correlation Between the Roentgenographic Appearance and Operative Findings at the Bone-Cement Junction of the Socket in Charnley Low Friction ArthroplastiesPublished by Ovid Technologies (Wolters Kluwer Health) ,1988
- Ultraclean air and antibiotics for prevention of postoperative infection: A multicenter study of 8,052 joint replacement operationsActa Orthopaedica, 1987
- Evaluation of Radiographic Findings in Painful Hip ArthroplastiesClinical Orthopaedics and Related Research, 1985