Validation of Synovial Aspiration in Girdlestone Hips for Detection of Infection Persistence in Patients Undergoing 2-Stage Revision Total Hip Arthroplasty

Background: The aim of this study was to assess the diagnostic performance of synovial aspiration in Girdlestone hips, without a Polymethylmethacrylate (PMMA) spacer, for the detection of infection persistence before total hip arthroplasty (THA) reimplantation. Methods: Seventy-four patients undergoing stage revision THA surgery were included in this retrospective cohort study. Both synovial cultures and serum C-reactive protein values were acquired before explantation of the THA and of the Girdlestone hip before reimplantation. Results: The diagnostic performance of the synovial aspiration of the Girdlestone hip achieved a sensitivity of only 13% and a specificity of 98%. The determination of the serum C-reactive protein value for Girdlestone hips achieved a sensitivity of 95% and a specificity of only 20%. Conclusions: Our data show that the Girdlestone aspiration can neither reliably confirm nor exclude a persistence of infection. (C) 2016 Elsevier Inc. All rights reserved.