Aspiration arthrography of the hip joint - Its uses and limitations in revision hip surgery

Seventy-one patients undergoing revision hip surgery over a 5-year period from 1988 to 1993 had aspiration arthrography of the hip as a preoperative investigation. Sixteen hips were found to be infected at operation. Preoperative aspiration yielded positive cultures in 11 of these 16 hips. There was identical correlation between the organisms isolated on aspiration and during surgery. There were 5 false positive cultures from the aspirates of the remaining 55 noninfected hips. All of the hips from which a true positive culture was obtained had either clinical or radiologic evidence suggestive of infection. Aspiration arthrography does nor have a major role to play as a routine investigation prior to all revision hip surgery. It is recommended that its use be reserved for those hips in which there is either clinical, hematologic, or radiologic evidence of infection.