Relation Between Prosthetic Joint Infections and Haematoma Contamination in Acute Fracture of the Neck of Femur

Background: The exact cause of positive intraoperative hematoma culture is unknown. Its incidence in the literature is about 11-35%. Objectives: This study aimed to evaluate positive intraoperative hematoma culture and its correlation to early postoperative prosthetic joint infection in the neck of femur fracture. Methodology: A prospective observational study was performed. 40 patients who underwent hip arthroplasty for femoral neck fracture were included. Two samples were taken and inoculated into conventional culture agar plate and BACT/ALERT. Patients received prophylaxis antibiotics with Teicoplanin 400mg. Results: A total of 40 patients were included in the study. In 16 patients (40%) intraoperative hematoma culture was positive by BACT/ALERT. Five patients (12.5%) developed an early prosthetic joint infection, four of them were positive for intraoperative hematoma culture. The rate of early wound infection in the group with positive hematoma contamination was 10% and in the negative hematoma culture was 2.5%. Conclusion: Intraoperative hematoma culture results using BACT/ALERT showed a statistically significant relation with clinical infections with an almost perfect measure of agreement.