Short- and medium-term clinical outcomes of culture-negative and culture-positive periprosthetic joint infection

Abstract Background:Periprosthetic joint infection(PJI)，as a complication of Total joint arthroplasty, is not uncommon nowdays.There are many treatments and the basic one is the application of antibiotics according to the culture results of synovial fluid or tissue specimens.Though many reasearchs have been done about the results of those treatments，but the differences of the effectiveness between culture-negative periprosthetic infection(CN PJI) and culture-positive periprosthetic infection(CP PJI) still remain unknow.So we conduct this study to compare the clinical outcomes of CN PJI with CP PJI.Methods: The clinical data of 77 patients with prosthetic infections were collected retrospectively. The mean follow-up time was 29.2 months (12-76 months). The remission rates of CN PJI and CP PJI were compared. The effects of the culture results on the curative effect were further compared by survival analysis. The correlations between sex, age, underlying diseases, sinus, disease course, joint involvement, surgical strategy, culture results and clinical outcomes were further analyzed by logistic regression.Results: In total, there were 24 cases of CN PJI, with an incidence of 29.63%. The overall success rate of CN PJI was 86.4% (19/22)，and overall success rate of CP PJI was 87.5% (42/48). There was no significant difference in the success rate between CN PJI and CP PJI. The incidence of antibiotic-related complications for CN PJI was significant higher than that for CP PJI, with 58.3% for CN PJI and 11.3% for CP PJI, respectively.Conclusion: CN PJI was treated according to the strict standards for the diagnosis and treatment, and the success rate of treatment for CN PJI was similar to that for CP PJI. The incidence of antibiotic-related complications from CN PJI was higher than that from CP PJI.