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

Abstract. Introduction: aspiration of total hip arthroplasty (THA) is commonly performed to assist in the diagnosis prosthetic joint infection (PJI). This study aimed determine whether fluoroscopic- or ultrasound- guided differs ability acquire synovial fluid and accuracy diagnosing infection. Methods: all THA aspirations between 2014 2021 at our institution were retrospectively identified. Aspirations classified as successful dry. If successful, volume obtained was recorded. The sensitivity specificity identifying PJI calculated with four methods: (1) culture results excluding saline lavage, (2) including (3) 2018 Musculoskeletal Infection Society (MSIS) International Consensus Meeting (ICM) criteria, (4) European Bone Joint (EBJIS) criteria. Analyses using Student's t test Wilcoxon rank sum for continuous variables chi-squared Fisher's exact categorical variables. Results: 290 included (155 fluoroscopic-guided 135 ultrasound-guided). Success (>0.5 mL) more common ultrasound cohort (69 %) than fluoroscopy (53 (p<0.0055). When (mean 13.1 mL vs. 10.0 mL; p=0.0002). Ultrasound-guided sensitive lavage (85 % 73 %; p=0.03), 69 p=0.001), MSIS-ICM criteria (77 52 p=0.02), EBJIS (87 65 p=0.02). specific (100 96 p=0.001). Conclusions: ultrasound-guided frequently yields THA. data,