Positive culture rate may be high in THA regardless of surgical preparation method
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Key takeaways:
- Overall, patients having total hip arthroplasty had an 11% positive culture rate.
- Positive culture rates were not significantly different for standard surgical preparation or preparation with benzoyl peroxide.
DALLAS — Results showed a high rate of Cutibacterium acnes for patients having total hip arthroplasty, with no significant difference in the positive culture rate between standard surgical preparation or preparation with benzoyl peroxide.
“We do not feel that the alternative preparation of benzoyl peroxide is warranted at this point, at least according to our data,” Jason M. Jennings, MD, DPT, an orthopedic surgeon at Colorado Joint Replacement, said in his presentation at the American Association of Hip and Knee Surgeons Annual Meeting. “There were many different organisms that we isolated in this study, and we are still unsure [of] the clinical significance of our findings.”
Jennings and colleagues randomly assigned patients undergoing THA to receive either standard surgical preparation (n = 173) or surgical preparation with benzoyl peroxide 48 hours before surgery (n = 164).
“All the patients in the standard group underwent our standard preparation prior to surgery. They got the chlorohexidine wipes before they went to the operative theater,” Jennings said. “The benzoyl peroxide group had the same wipes; but 48 hours before surgery, we did a total of four doses of benzoyl peroxide in a topical fashion, with the last dose being the morning of surgery in our preoperative holding area.”
Jennings said the primary study objective was to observe C. acnes colonization in patients undergoing THA, while the secondary objective was to identify any differences in hypothetical incisions of anterior or lateral surgery.
Among 2,000 biopsies, Jennings said there was an 11% positive culture rate for a total of 223 cultures.
“There was no significant difference with any positive culture that we obtained between the standard and topical benzoyl peroxide group,” Jennings said.
He added the standard group had an incidence of 17% for C. acnes positive cultures vs. 20% incidence in the benzoyl peroxide group.
The most common organisms identified in both groups included C. acnes and Staphylococcus aureus, according to Jennings.
“We found no differences between surgical approaches with an anterior lateral sampling and no difference between proximal, middle or distal biopsy sites,” he said.
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Jennings JM, et al. Paper 33. Presented at: American Association of Hip and Knee Surgeons Annual Meeting; Nov. 7-10, 2024; Dallas.
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