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26Postoperative diagnosis and outcome in patients with revision arthroplasty for aseptic loosening

Overview of attention for article published in BMC Infectious Diseases, June 2015
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Title
26Postoperative diagnosis and outcome in patients with revision arthroplasty for aseptic loosening
Published in
BMC Infectious Diseases, June 2015
DOI 10.1186/s12879-015-0976-y
Pubmed ID
Authors

Marta Fernandez-Sampedro, Carlos Salas-Venero, Concepción Fariñas-Álvarez, Manuel Sumillera, Luis Pérez-Carro, Michel Fakkas-Fernandez, Javier Gómez-Román, Luis Martínez-Martínez, María Carmen Fariñas

Abstract

The most common cause of implant failure is aseptic loosening (AL), followed by prosthetic joint infection (PJI). This study evaluates the incidence of PJI among patients operated with suspected AL and whether the diagnosis of PJI was predictive of subsequent implant failure including re-infection, at 2 years of follow up. Patients undergoing revision hip or knee arthroplasty due to presumed AL from February 2009 to September 2011 were prospectively evaluated. A sonication fluid of prosthesis and tissue samples for microbiology and histopathology at the time of the surgery were collected. Implant failure include recurrent or persistent infection, reoperation for any reason or need for chronic antibiotic suppression. Of 198 patients with pre-and intraoperative diagnosis of AL, 24 (12.1 %) had postoperative diagnosis of PJI. After a follow up of 31 months (IQR: 21 to 38 months), 9 (37.5 %) of 24 patients in the PJI group had implant failure compared to only 1 (1.1 %) in the 198 of AL group (p < 0.0001). Sensitivity of sonicate fluid culture (>20 CFU) and peri-prosthetic tissue culture were 87.5 % vs 66.7 %, respectively. Specificities were 100 % for both techniques (95 % CI, 97.9-100 %). A greater number of patients with PJI (79.1 %) had previous partial arthroplasty revisions than those patients in the AL group (56.9 %) (p = 0.04). In addition, 5 (55.5 %) patients with PJI and implant failure had more revision arthroplasties during the first year after the last implant placement than those patients with PJI without implant failure (1 patient; 6.7 %) (RR 3.8; 95 % CI 1.4-10.1; p = 0.015). On the other hand, 6 (25 %) patients finally diagnosed of PJI were initially diagnosed of AL in the first year after primary arthroplasty, whereas it was only 16 (9.2 %) patients in the group of true AL (RR 2.7; 95 % CI 1.2-6.1; p = 0.03). More than one tenth of patients with suspected AL are misdiagnosed PJI. Positive histology and positive peri-implant tissue and sonicate fluid cultures are highly predictive of implant failure in patients with PJI. Patients with greater number of partial hip revisions for a presumed AL had more risk of PJI. Early loosening is more often caused by hidden PJI than late loosening.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 65 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 65 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 12 18%
Researcher 11 17%
Other 7 11%
Student > Bachelor 4 6%
Student > Postgraduate 4 6%
Other 12 18%
Unknown 15 23%
Readers by discipline Count As %
Medicine and Dentistry 34 52%
Engineering 4 6%
Agricultural and Biological Sciences 2 3%
Sports and Recreations 2 3%
Immunology and Microbiology 1 2%
Other 3 5%
Unknown 19 29%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 18 June 2015.
All research outputs
#3,683,431
of 5,234,334 outputs
Outputs from BMC Infectious Diseases
#2,073
of 2,778 outputs
Outputs of similar age
#129,223
of 184,395 outputs
Outputs of similar age from BMC Infectious Diseases
#79
of 101 outputs
Altmetric has tracked 5,234,334 research outputs across all sources so far. This one is in the 16th percentile – i.e., 16% of other outputs scored the same or lower than it.
So far Altmetric has tracked 2,778 research outputs from this source. They receive a mean Attention Score of 3.2. This one is in the 6th percentile – i.e., 6% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 184,395 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 18th percentile – i.e., 18% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 101 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.