Articles | Volume 8, issue 3
Original full-length article
09 May 2023
Original full-length article |  | 09 May 2023

Is ultrasound-guided hip aspiration more successful than fluoroscopic-guided aspiration in diagnosing prosthetic joint infection?

Emily A. Treu, Daniel M. Cushman, John C. Wheelwright, Brenna E. Blackburn, Masaru Teramoto, and Michael J. Archibeck

Related subject area

Subject: Prosthesis-related infections | Topic: Other
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Cited articles

Ali, F., Wilkinson, J. M., Cooper, J. R., Kerry, R. M., Hamer, A. J., Norman, P., and Stockley, I.: Accuracy of joint aspiration for the preoperative diagnosis of infection in total hip arthroplasty, J. Arthroplasty, 21, 221–226,, 2006. 
Barrack, R. L. and Harris, W. H.: The value of aspiration of the hip joint before revision total hip arthroplasty, J. Bone Joint Surg. Am., 75, 66–76,, 1993. 
Battaglia, M., Vannini, F., Guaraldi, F., Rossi, G., Biondi, F., and Sudanese, A.: Validity of preoperative ultrasound-guided aspiration in the revision of hip prosthesis, Ultrasound Med. Biol., 37, 1977–1983,, 2011. 
Berbari, E. F., Hanssen, A. D., Duffy, M. C., Steckelberg, J. M., Ilstrup, D. M., Harmsen, W. S., and Osmon, D. R.: Risk factors for prosthetic joint infection: case-control study, Clin. Infect. Dis., 27, 1247–1254,, 1998. 
Berend, K. R., Lombardi Jr., A. V., Morris, M. J., Bergeson, A. G., Adams, J. B., and Sneller, M. A.: Two-stage treatment of hip periprosthetic joint infection is associated with a high rate of infection control but high mortality, Clin. Orthop. Relat. R., 471, 510–518,, 2013. 
Short summary
Our study showed that ultrasound-guided aspiration of a total hip arthroplasty was more commonly successful and resulted in fewer dry aspirations than fluoroscopy. Ultrasound-guided aspiration yielded a larger volume of fluid than fluoroscopy, even when excluding dry aspirations. Ultrasound was more sensitive than fluoroscopy in diagnosing prosthetic joint infection (PJI) using culture results only and 2018 Musculoskeletal Infection Society (MSIS) International Consensus Meeting (ICM) criteria.