Observational studyThe Journal of arthroplasty2019
Do Culture Negative Periprosthetic Joint Infections Remain Culture Negative?
Observational study in The Journal of arthroplasty, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Comparative diagnostic accuracy of next-generation sequencing in different specimen types for periprosthetic joint infection: A systematic review and meta-analysis.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Pooled it
- Outcomes of culture-negative or -positive periprosthetic joint infections: A systematic review and meta-analysis.Joint diseases and related surgery · 2024Pooled it
- Machine Learning-Driven Probability Scoring Enhances Diagnostic Certainty and Reduces Costs in Suspected Periprosthetic Joint Infection.Diagnostics (Basel, Switzerland) · 2026Article
- Article
- Timing-specific Debridement, Antibiotics, and Implant Retention and 2-Stage Revision for Megaprosthesis-Related Infection: Optimizing the Window Period for Improved Outcomes.Arthroplasty today · 2025Article
- Agreement Analysis Among Hip and Knee Periprosthetic Joint Infections Classifications.Diagnostics (Basel, Switzerland) · 2025Article
- Suction-Powered Intramedullary Bone Debridement Technology Compared to Conventional Curettage in Infected Revision Total Knee Arthroplasty.Arthroplasty today · 2025Article
- Effects of COVID-19 on short-term outcomes of hip arthroplasty: a multicenter, retrospective, propensity score matched study.BMC musculoskeletal disorders · 2025Article
- Clinical characteristics of culture-negative periprosthetic joint infections: findings from an international periprosthetic joint infection registry.Journal of bone and joint infection · 2025Article
- The role of the medial head of the gastrocnemius myocutaneous flap transfer in the management of prosthesis exposure and deep joint infection following total knee arthroplasty.Archives of orthopaedic and trauma surgery · 2024Article
- The Impact of Culture Negativity on the Outcomes of Revision Total Knee Arthroplasty for Chronic PJI.Microorganisms · 2024Article
- Optimal selection of specimens for metagenomic next-generation sequencing in diagnosing periprosthetic joint infections.Frontiers in cellular and infection microbiology · 2024Article
- Profiling the Immune Response to Periprosthetic Joint Infection and Non-Infectious Arthroplasty Failure.Antibiotics (Basel, Switzerland) · 2023Review
- Risk factors of reinfection after prosthesis removal and antibiotic bone cement spacer implantation for the treatment of periprosthetic joint infection.BMC infectious diseases · 2022Article
- Worse outcome of debridement, antibiotics, and implant retention in acute hematogenous infections than in postsurgical infections after total knee arthroplasty: a multicenter study.Knee surgery & related research · 2022Article
- Antibiotic Therapy for Prosthetic Joint Infections: An Overview.Antibiotics (Basel, Switzerland) · 2022Review
- Application of leukocyte esterase strip test in the screening of periprosthetic joint infections and prospects of high-precision strips.Arthroplasty (London, England) · 2020Review
- Staphylococcus aureus Osteomyelitis: Bone, Bugs, and Surgery.Infection and immunity · 2020Review
- Engineered Cationic Antimicrobial Peptides (eCAPs) to Combat Multidrug-Resistant Bacteria.Pharmaceutics · 2020Review
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundDiagnosis and treatment of culture negative total knee arthroplasty (TKA) periprosthetic joint infection (PJI) is challenging. There is debate over whether culture negative PJI confers increased risk of failure and which organisms are responsible. It is also unclear as to what factors predict conversion from culture negative to culture positivity. To address these issues, we performed an observational study to detect factors associated with transition from culture negative to culture positive TKA PJI in those patients that failed irrigation and debridement (I&D), determine the incidence of this transition, and identify those organisms that were associated with treatment failure.
methodsA multicenter observational cohort study was performed on patients with TKA PJI as defined by Musculoskeletal Infection Society criteria without cultured organisms and treated with I&D. Primary outcome was failure defined as any subsequent surgical procedure. Secondary outcome included cultured organism within 2 years of initial I&D.
resultsTwo hundred sixteen TKA I&D procedures were performed for PJI, and 36 met inclusion criteria. The observed treatment failure rate for culture negative PJI treated with I&D was 41.67%. Of those culture negative I&Ds that failed, 53.33% became culture positive after failure. Of those that converted to culture positive, 62.5% were Staphylococcus species. The odds ratio associated with becoming culture positive following culture negative treatment failure in the setting of antibiotic administration prior to the initial I&D procedure was 0.69 (95% confidence interval 0.14-3.47, P = .65).
conclusionMany cases of culture negative TKA PJI treated with I&D eventually fail and become culture positive. Staphylococci are common organisms identified after culture negative PJI.
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