Should antibiotics be withheld before revision surgery? Are the rules for hip/knee the same as for shoulder?
The chitranjan ranawat award: should prophylactic antibiotics be withheld before revision surgery to obtain appropriate cultures? The authors point out that on one hand, preoperative antibiotics are known to be critical for decreasing the risk of periprosthetic joint infection and on the other hand preoperative antibiotics may affect the surgeons ability to obtain meaningful intraoperative cultures. The authors studied 65 patients with known preprosthetic joint infections after 37 TKAs and 28 THAs as documented by a culture-positive aspiration. Patients were randomized to receive prophylactic antibiotics either before the skin incision or after a minimum of three sets of intraoperative cultures were obtained. There was no significant difference: intraoperative cultures yielded the same organisms as preoperative cultures in 28 of 34 patients (82%) randomized to receive antibiotics before the skin incision compared to 25 of 31 patients (81%) randomized to receive antibiotics after obtain...