Aseptic Loosening of Total Hip Arthroplasty: Are They All Truly Aseptic?

Microorganisms can simply live in glycocalyx-enclosed biofilms that are adherent to surfaces of implanted prostheses without presenting with florid clinical signs of infection. The detection of infection in these circumstances still presents a challenge. Differentiation between aseptic loosening and failures attributable to periprosthetic joint infection (PJI) is critical, so that proper intervention can be implemented. The aim of our study was to determine if patients with failure for aseptic loosening are properly evaluated for infection prior to revision surgery. Patients developing infection after revision for an aseptic failure were evaluated in detail to assess the accuracy of diagnosis of aseptic failure.