Articles | Volume 7, issue 6
13 Dec 2022
Review |  | 13 Dec 2022

The concordance between preoperative synovial fluid culture and intraoperative tissue cultures in periprosthetic joint infection: a systematic review

Thomas J. A. van Schaik, Lex D. de Jong, Maurits P. A. van Meer, Jon H. M. Goosen, and Matthijs P. Somford

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Cited articles

Ahmad, S. S., Shaker, A., Saffarini, M., Chen, A. F., Hirschmann, M. T., and Kohl, S.: Accuracy of diagnostic tests for prosthetic joint infection: a systematic review, Knee Surg. Sports Traumatol. Arthrosc., 24, 3064–3074,, 2016. 
American Academy of Orthopaedic Surgeons: Diagnosis and Prevention of Periprosthetic Joint Infections Evidence-Based Clinical Practice Guideline, (last access: 10 December 2022), 11 March 2019. 
Atkins, B. L., Athanasou, N., Deeks, J., Crook, D. W. M., Simpson, H., Peto, T., Mclardy-Smith, P., Berendt, A. R., Benson, M., Carr, A., Collopy, D., Cooke, P., Kenwright, J., McClardy-Smith, P., Simpson, H., de Steiger, R., Gundle, R., Willett, K., Atkins, B., Berendt, A., Bowler, I., Conlon, C., Crook, D., Emptage, A., and Athanasou, N.: Prospective evaluation of criteria for microbiological diagnosis of prosthetic-joint infection at revision arthroplasty. The OSIRIS Collaborative Study Group, J. Clin. Microbiol., 36, 2932–2939,, 1998. 
Boyle, K. K., Kapadia, M., Chiu, Y. F., Khilnani, T., Miller, A. O., Henry, M. W., Lyman, S., and Carli, A. V.: The James A. Rand Young Investigator's Award: Are Intraoperative Cultures Necessary If the Aspiration Culture Is Positive? A Concordance Study in Periprosthetic Joint Infection, J. Arthroplasty, 36, S4–S10,, 2021. 
Christensen, T. H., Ong, J., Lin, D., Aggarwal, V. K., Schwarzkopf, R., and Rozell, J. C.: How Does a “Dry Tap” Impact the Accuracy of Preoperative Aspiration Results in Predicting Chronic Periprosthetic Joint Infection?, J. Arthroplasty, 37, 925–929,, 2022. 
Short summary
This systematic review presents the results regarding the concordance rate between preoperative synovial fluid and intraoperative tissue culturing in patients with a prosthetic joint infection (PJI). The included studies had heterogeneous results and were at a high risk of bias. Higher-quality future research may help to better understand the true concordance between these cultures. This may result in better guidance for orthopedic surgeons regarding the treatment of patients with PJI.