ReviewJournal of orthopaedics
Unexpected positive intraoperative cultures (UPIC) in revision Hip and knee arthroplasty- A review of the literature.
Review in Journal of orthopaedics. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 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
18 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Unexpected positive culture (UPC) in adults revision spine surgery: a systematic review and meta-analysis of incidence, risk factors, and management.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024Pooled it
- Prevalence, interpretation, and management of unexpected positive cultures in revision TKA: a systematic review.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Pooled it
- Postoperative Antibiotic Duration and Treatment Failure After Aseptic Revision Arthroplasty With a Single Unexpected Positive Culture: A Retrospective Cohort Study.Orthopaedic surgery · 2026Article
- The boundary between microbial detection and implant-related infection: a structured narrative review of analytical credibility, biological persistence, host response, and clinical causality.Archives of orthopaedic and trauma surgery · 2026Review
- Unexpected Positive Cultures During Aseptic Hip and Knee Revision Arthroplasty: Substantial Discrepancies in Laboratory Analyses.Antibiotics (Basel, Switzerland) · 2025Article
- Postoperative antibiotic treatment does not lower re-revision rate in presumed aseptic hip and knee revision arthroplasties with unexpected positive intraoperative cultures - a matched cohort study.Journal of bone and joint infection · 2025Article
- Difficulty of diagnostic accuracy of periprosthetic joint infection: a retrospective analysis of revision surgery of total hip arthroplasty and total knee arthroplasty in a tertiary hospital.BMC musculoskeletal disorders · 2024Article
- Unexpected positive cultures in conversion hip and knee arthroplasty.International orthopaedics · 2024Article
- Undiagnosed Periprosthetic Infections in First-Time Aseptic Revision Hip Arthroplasties.Biomedicines · 2024Article
- Prevalence, risk factors, microbiological results and clinical outcome in unexpected positive intraoperative cultures in unclear and presumed aseptic hip and knee revision arthroplasties - A ten-year retrospective analysis with a minimum follow up of 2 years.Journal of orthopaedic translation · 2024Article
- Unexpected positive cultures in patients with arthrofibrosis following total hip and total knee arthroplasty.International orthopaedics · 2024Article
- Antibiotic prophylaxis before tissue biopsy has no effect on culture results in presumed aseptic revision total hip arthroplasty.Journal of bone and joint infection · 2024Article
- Multiplex PCR test as an intra-operative diagnostic tool for periprosthetic joint infection in presumed aseptic revision hip and knee arthroplasty: a 1-year follow-up study of 200 cases.Journal of bone and joint infection · 2024Article
- Alpha-defensin as a diagnostic tool in revision total knee arthroplasties with unexpected positive intraoperative cultures and unexpected culture negative intraoperative cultures.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Microbiological Advantages of Open Incisional Biopsies for the Diagnosis of Suspected Periprosthetic Joint Infections.Journal of clinical medicine · 2022Article
- Unexpected positive intraoperative cultures (UPIC) at index osseointegration do not lead to increased postoperative infectious events.Journal of bone and joint infection · 2022Article
- Should all hip and knee prosthetic joints be aspirated prior to revision surgery?Archives of orthopaedic and trauma surgery · 2021Article
- Surgical management of hip prosthetic failure in metallosis: A case series and literature review.Journal of orthopaedicsReview
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Unexpected positive intraoperative culture (UPIC) in revision hip and knee arthroplasty has a prevalence of 10.5%, there is no consensus in the literature on how to interpret them and how to treat them. Our literature review showed that most authors would consider two or more positive cultures as significant and usually treat them with culture specific antibiotics for 4-6 weeks. A single positive intraoperative culture can or cannot be significant depending on the virulence of the organism, hence taking multiple tissue samples in and around the joint is recommended. All failed arthroplasty cases must be evaluated preoperatively according to musculoskeletal infection society criteria (MSIS) to rule out the possibility of infection as an etiology for failure of the arthroplasty. Most authors reported that large majority of these UPIC were from a low virulence organism. Our review showed that the implant survival is more than 85% with 4-6 weeks of antibiotic treatment.
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