Microbial Colonization of Capsular Traction Sutures in Hip Arthroscopic Surgery

Abstract

Background: A common practice in hip arthroscopic surgery is the utilization of capsular traction sutures that can be incorporated into the capsular repair site at the end of the procedure, potentially seeding the hip joint with colonized suture material. Purpose: To investigate the rate of the microbial colonization of capsular traction sutures used during hip arthroscopic surgery and to identify patient-associated risk factors for this microbial colonization. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 50 consecutive patients who underwent hip arthroscopic surgery with a single surgeon were enrolled. There were 4 braided nonabsorbable sutures utilized for capsular traction during each hip arthroscopic procedure. These 4 traction sutures and 1 control suture were submitted for aerobic and nonaerobic cultures. Cultures were held for 21 days. Demographic information was collected, such as age, sex, and body mass index. All variables underwent bivariate analysis, and variables with a P value <.1 underwent further analysis in a multivariate logistic regression model. Results: One of 200 experimental traction sutures and 1 of 50 control sutures had a positive culture. Proteus mirabilis and Citrobacter koseri were isolated in both these positive experimental and control cultures from the same patient. Age and traction time were not significantly associated with positive cultures. The rate of microbial colonization was 0.5%. Conclusion: The rate of the microbial colonization of capsular traction sutures used in hip arthroscopic surgery was low, and no patient-associated risk factors were identified for microbial colonization. Capsular traction sutures used in hip arthroscopic surgery were not a significant potential source of microbial contamination. Based on these results, capsular traction sutures can be incorporated in capsular closure with a low risk of seeding the hip joint with microbial contaminants.

Use of Biomaterials in 3D Printing as a Solution to Microbial Infections in Arthroplasty and Osseous Reconstruction

“…Although metal prostheses come with many advantages, from manufacturing to in-body responses, disadvantages can occur in the case of patients allergic to metals [ 59 ]. Research has likewise been conducted in regard to the efficacy of the incorporation of capsular traction sutures and it was concluded that they carry a low risk of colonization and thus can be used quite safely in hip arthroscopic surgery [ 60 ]. Other researchers have found out that the application of a cyanoacrylate-based skin sealant, called InteguSeal, seems to be beneficial during trauma surgery albeit without the results being conclusive [ 61 ].…”

“…The main risk stems from Staphylococcus epidermidis , Staphylococcus aureus , Staphylococcus pettenkoferi , and Micrococcus luteus bacteria [ 66 ] while Proteus mirabilis and Citrobacter koseri have also been implicated [ 60 ]. Staphylococcus aureus in particular may be responsible for septic arthritis and osteomyelitis, two severe conditions [ 29 ].…”