Efficacy of Preoperative Aspiration in Diagnosis of Peripros
What about synovial fluid aspiration?
Preoperative synovial fluid aspiration is an important diagnostic test for shoulder PJI, as it provides the opportunity to diagnose infection prior to revision surgery. However, obtaining an adequate fluid sample for testing from the shoulder can be more challenging because of the decreased synovial fluid volumes that are present relative to the hip and knee. Due to this increased difficulty in aspirating the shoulder, limited data is available on its efficacy in diagnosis of shoulder PJI. Our group’s recent study sought to determine the rate of successful preoperative synovial fluid aspiration and its effectiveness in diagnosis of PJI in patients undergoing revision shoulder arthroplasty.

Study design
Our review included 202 cases evaluated for painful shoulder arthroplasty at Cleveland Clinic between January 2009 and February 2015. In 110 cases, a preoperative fluid aspiration was obtained and sent for culture, and 97 of these cases went on to revision arthroplasty surgery. Mean age at the time of surgery was 63.2 years (range, 29-89). We identified all cases of attempted preoperative aspiration to determine the incidence of successful and unsuccessful aspiration. Preoperative synovial fluid culture results were then compared to culture results at the time of revision surgery to determine the efficacy of preoperative synovial fluid aspiration for diagnosis of shoulder PJI....