Preoperative Aspiration Culture (PAC) for the Diagnosis of Infection in a Prosthetic Knee Joint

Background: Periprosthetic infection is the most serious joint replacement complication, occurring in 0.8-1.9% of total knee arthroplasties (TKAs). This review aims to define the role of preoperative aspiration culture (PAC) for diagnosis of TKA infection. Methods: A PubMed (MEDLINE) search related to TKA infection and PAC was analyzed. The main criteria for selection were that the articles were focused in the aforementioned question. Results: Twenty articles were found, but only fourteen were selected and reviewed because they were deeply focused on the topic. PAC has shown an average sensitivity of 67.6% (range, 28% to 100%) and an average specificity of 98.4% (range, 96% to 100%). Conclusion: PAC has moderate to high sensitivity and very high specificity for diagnosing TKA infection. Level of evidence: III