Prevalence of unexpected positive intraoperative cultures in hip arthroplasty and their impact on the result and survival of the prosthesis
[eng] INTRODUCTION: Total hip arthroplasty (TKA) is performed more and more frequently due to the increase in indications and longer life expectancy. Approximately 12% will require revision surgery at 10-15 years, with aseptic loosening being the main indication. An adequate differential diagnosis b...
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| Format: | doctoral thesis |
| Status: | Published version |
| Publication Date: | 2025 |
| Country: | España |
| Institution: | Universidad de Barcelona |
| Repository: | Dipòsit Digital de la UB |
| OAI Identifier: | oai:diposit.ub.edu:2445/221667 |
| Online Access: | https://hdl.handle.net/2445/221667 http://hdl.handle.net/10803/694700 |
| Access Level: | Open access |
| Keyword: | Cirurgia ortopèdica Artroplàstia Pròtesis de maluc Infeccions Orthopedic surgery Arthroplasty Hip prosthesis Infections |
| Summary: | [eng] INTRODUCTION: Total hip arthroplasty (TKA) is performed more and more frequently due to the increase in indications and longer life expectancy. Approximately 12% will require revision surgery at 10-15 years, with aseptic loosening being the main indication. An adequate differential diagnosis between aseptic and septic loosening is essential, as they require radically different treatments. The preoperative study is based on a series of criteria that allow a presumptive diagnosis to be made. However, it is not uncommon to unexpectedly find positive intraoperative cultures in cases that previously seemed aseptic. The impact of this finding on primary and replacement surgery is a current topic of debate. HYPOTHESIS: The presence of unexpectedly positive cultures in primary surgery for TCA worsens its prognosis. In TCA requiring prior excision of osteosynthesis material, the presence of unexpectedly positive cultures also has a negative impact on implant outcome and survival. In revision surgeries, total or partial, unexpectedly positive cultures increase the risk of re-revision, worsening implant survival. OBJECTIVES: 1. To determine the prevalence of unexpectedly positive cultures in primary TCA and to assess their impact on implant outcome and survival. 2. To determine the prevalence of unexpectedly positive cultures in TCA after excision of osteosynthesis material in a single surgical time and to analyze their impact on implant outcome and survival. 3. To determine the prevalence of unexpectedly positive cultures in total hip replacement and to analyse their impact on implant outcome and survival. 4. To determine the prevalence of unexpectedly positive cultures in partial replacement of hip arthroplasty and to analyze their impact on implant outcome and survival. |
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