ArticleArchives of orthopaedic and trauma surgery2023
Treatment outcomes of patients with Cutibacterium acnes-positive cultures during total joint replacement revision surgery: a minimum 2-year follow-up.
Article in Archives of orthopaedic and trauma surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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8 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Optimized use and performance of culture for periprosthetic joint infection diagnosis: a comprehensive literature review.Clinical microbiology reviews · 2025Pooled it
- Histological Analysis of Acetabular Bone Impaction Grafting According to Slooff 15 Years After Implantation.Case reports in orthopedics · 2026Article
- Microbial next generation DNA sequencing of aspirated synovial fluid shows concordance with ICM criteria biomarkers for diagnosing periprosthetic joint infection in hip and knee arthroplasty.Frontiers in microbiology · 2026Article
- Characterization ofFrontiers in surgery · 2026Article
- Synergistic Antimicrobial Activity of Vancomycin, Ceftriaxone, and Gentamicin AgainstAntibiotics (Basel, Switzerland) · 2025Article
- Evaluation of sonication for the detection of periprosthetic joint infection in hip revision arthroplasty: a retrospective observational single-center study of 288 episodes.Acta orthopaedica · 2025Observational
- Cutibacterium infections after total hip arthroplasty: does surgical approach play a role?International orthopaedics · 2025Article
- Spontaneous Clavicular Osteomyelitis Caused by Cutibacterium acnes Treated with Calcium Sulfate Beads.Journal of orthopaedic case reports · 2025Article
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8 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
introductionPeriprosthetic joint infection (PJI) is a devastating complication following total joint replacement (TJR). Cutibacterium acnes (C. acnes) is a low virulent skin commensal, commonly found during TJR revision surgery for "aseptic" causes. The purpose of the present study was to report the treatment outcomes of patients with C. acnes contamination or infection in the presence of a TJR treated with a revision surgery ± implant exchange ± prolonged (≥ 8 weeks) postoperative antibiotics.
methodsMedical records of patients with at least one positive C. acnes culture in intraoperative tissue samples or sonication fluid from a TJR revision surgery between January 2005 and December 2014 were retrospectively evaluated. The primary endpoint was infection eradication according to Delphi criteria. The diagnostic accuracy of preoperative TJR aspiration regarding the diagnosis of C. acnes PJI was also investigated.
resultsA total of 52 TJR (28 shoulders, 17 hips, 7 knees) in 52 patients (35 males, 17 females) with an average age of 63 ± 11 (33-86) years were included. At an average follow-up of 67 ± 33 (24-127) months, the infection eradication of C. acnes PJI was 97% regardless of the surgical treatment or administration of prolonged postoperative antibiotics. The incidence of unsuspected C. acnes PJI was 28.8%. The sensitivity and specificity of preoperative joint aspiration in detecting C. acnes PJI were 59% and 88%, whereas the PPV and NNV were 83% and 67%, respectively.
conclusionInfection eradication of C. acnes PJI was very high at a minimum follow-up of 24 months, suggesting that C. acnes PJI could be adequately treated with a combination of revision surgery and prolonged postoperative antibiotics. The preoperative diagnosis of C. acnes PJI might be challenging with more than one-quarter of patients presenting without suspicion of C. acnes PJI. The appropriate treatment of patients with a single positive culture remains still unclear. A negative TJR aspiration should not rule out a C. acnes PJI, especially in the presence of clinical correlates of infection. LEVEL OF EVIDENCE: Retrospective case-control study, Level III. IRB APPROVAL: Kantonale Ethikkommission Zürich, BASEC Nr.:2017-00567.
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