Gram stain detection of infection during revision arthroplasty

We reviewed 194 revision arthroplasties of the hip and knee performed over a ten-year period. The results of intraoperative Gram staining were available in 169 (87%). Thirty-two were found to be infected (11 hips and 21 knees) and 137 had no evidence of infection. Intraoperative Gram staining was negative in all 169 cases. The method therefore had a sensitivity of 0% for detecting infection. We conclude that the absence of organisms on intraoperative Gram staining during revision arthroplasty does not confirm the absence of infection.

GRAM STAIN DETECTION OF INFECTION DURING REVISION ARTHROPLASTY

We reviewed 194 revision arthroplasties of the hip and knee performed over a ten-year period. The results of intraoperative Gram staining were available in 169 (87%). Thirty-two were found to be infected (11 hips and 21 knees) and 137 had no evidence of infection.

Intraoperative Gram staining was negative in all 169 cases. The method therefore had a sensitivity of 0% for detecting infection. We conclude that the absence of organisms on intraoperative Gram staining during revision arthroplasty does not confirm the absence of infection.

Intraspinal extradural ganglion cyst

Occurrence of ganglion cysts in the spine is extremely rare. Common symptoms include intermittent lumbar pain and pain at night. Neurological examination to distinguish from other etiologies of radicular pain may be difficult. The L4-L5 level is the most common sight of occurrence. Radiographically, degenerative changes, particularly spondylolisthesis, are a common finding. MRI appearance of the cysts is variable, according to the composition of the cyst. A ganglion cyst should be considered in the differential of radicular pain in the presence of degenerative changes of the lumbar spine.