Clin Orthop Surg.  2013 Jun;5(2):105-109. 10.4055/cios.2013.5.2.105.

Microbiological Culture Findings of the Femoral Heads as a Prognostic Factor in the Total Hip Replacement Surgery

• Phuong DT
• Park KS
• Hwang SY
• Lee DH
• Yoon TR

• KMID: 1705530
• DOI: http://doi.org/10.4055/cios.2013.5.2.105

Abstract

BACKGROUND
In primary total hip replacements (THRs), the dissected femoral heads (FHs) are commonly used to make the bone-chips for the reconstruction in the orthopaedic surgery. The donated FHs are routinely microbiologically cultured to identify and contaminated FHs are discarded. This study examines whether a positive FH culture predicts an infection and prosthetic failure after primary THR.
METHODS
The study sampled 274 donated FHs from patients with osteonecrosis (ON), hip joint osteoarthritis (OA), and femoral neck fracture (FNF) in THR to culture the microbes. The FH contamination rates were analyzed for ON, OA, and FNF groups. Proportion of the postoperative infection or prosthetic failure in the group of donors with a positive FH culture were compared to the proportion in the group of donors with a negative FH culture.
RESULTS
The rates of the positive culture in the ON, OA, and FNF groups were 7.1%, 3.8%, and 4.0%, respectively. The infection rate was found to be non-significantly greater in the ON group than in the OA and FNF groups. In the negative culture group, one patient (0.63%) had a postoperative superficial infection, and five patients (3.2%) experienced additional surgeries including a fixation for a periprosthetic fracture, within a minimum follow-up of two years. However, no postoperative infection was encountered, and no revision surgery was required in the positive culture group.
CONCLUSIONS
A positive FH culture is not always associated with elevated risks of infection or prosthetic failure after THR. Therefore, such finding cannot be used as a prognostic factor of THR. The FHs that return a positive culture may not lead to the orthopaedic assessment of an infection or other postoperative complication risks in primary THR.

Keyword

Femoral head; Positive culture; Total hip replacement

MeSH Terms

Adult
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip/adverse effects/*methods
Female
Femoral Neck Fractures/surgery
Femur Head/*microbiology
Humans
Male
Middle Aged
Osteoarthritis, Hip/surgery
Osteonecrosis/surgery
Prognosis
Prosthesis-Related Infections/*microbiology
Staphylococcus/isolation & purification

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