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Joint aspiration prior to reimplantation may not influence outcomes

Joint aspiration prior to reimplantation may not influence outcomes



Chisari E, et al. Paper 1661. Presented at: EFORT Annual Congress; June 22-24, 2022; Lisbon, Portugal.

Chisari reports no relevant financial disclosures.

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Joint aspiration in patients with periprosthetic joint infection may not influence the outcome of reimplantation, according to results presented at the EFORT Annual Congress.

“There is not necessarily a guideline or a clear recommendation about doing [joint aspiration] or not, but the problem that we experience clinically is that when you have a spacer inside your joint or you have done multiple surgeries, it is usually hard to aspirate any fluid from that joint,” Emanuele Chisari, MD, of Rothman Orthopaedic Institute at Thomas Jefferson University, told Healio. “Many physicians worry about doing a reimplantation before being able to aspirate and then do a typical analysis, like synovial fluid, leukocyte differential or some kind of biomarker.”

Chisari added, “We wanted to see if the actual action of doing an aspiration was of any use for physician judgement and then to influence the success rate or not.”

Emanuele Chisari

Emanuele Chisari

Chisari and colleagues retrospectively reviewed data for patients with chronic and acute periprosthetic joint infections who underwent two-stage exchange from 2000 to 2019 and categorized patients into groups based on whether they had both serum and synovial markers before reimplantation, had serum markers but a dry tap at the time of joint aspiration or if they did not undergo aspiration before reimplantation.

Results showed that aspiration did not influence the success rate, with no differences in the success rate among the three groups. Patients who did not undergo aspiration before reimplantation had a shorter mean time to reimplantation, according to researchers. Chisari also noted all three groups had similar rates of complication and reoperation.

“I was hoping that people who underwent aspiration, therefore went through an initial diagnostic procedure, would have a better survival rate and a lower failure rate, but that is the beauty of research,” Chisari said.