Comparable outcome of culture-negative and culture-positive periprosthetic hip joint infection for patients undergoing two-stage revision

Purpose Lack of peri-operative microbiological evidence is an unfavourable factor in one-stage revision. The objective of this study was to figure out whether being culture-negative was an unfavourable factor for periprosthetic hip joint infection (PHJI) in patients undergoing two-stage revision. Methods Records of PHJI patients treated between October 2003 and December 2016 were reviewed at our institution. Information such as microbiological data, clinical outcomes, and other details of patients' clinical courses were recorded. Results A total of the 58 cases were reviewed. The median follow-up duration was 68.5 months. The infection control rate of PHJI was 93.1% after two-stage revision. Kaplan-Meier analysis showed no significant difference in infection control rates between culture-negative and culture-positive groups. Culture-positive sinus secretions were significantly associated with an increased rate of reinfection (P = 0.039). Conclusions Two-stage revision had a high success rate for eradication of PHJI. Culture-negative PHJI had a comparable outcome with culture-positive PHJI.