To investigate the discordance between preoperative synovial fluid cultures and intraoperative cultures in patients undergoing revision arthroplasty for periprosthetic joint infection (PJI).
Key Findings:
Discordance between preoperative and intraoperative cultures was observed in 36% of cases.
Partial discordance occurred in 26% of cases.
Center-specific variation was significant, with one center showing over twice the discordance rate compared to others.
Hip arthroplasty patients had 1.6 times higher odds of discordance than knee patients.
Patients with a sinus tract had 1.8 times higher odds of discordance.
Interpretation:
Preoperative synovial fluid cultures may not reliably reflect intraoperative microbiology, necessitating consideration of clinical context and institutional practices.
Limitations:
Retrospective design with potential missing data for key variables.
Disproportionate influence of one high-discordance center.
Lack of detailed demographic data may limit generalizability.
Conclusion:
Awareness of discordance rates and associated risk factors is crucial for optimizing perioperative management and improving patient outcomes in PJI.
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