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This study compares patients with and without preoperative pathogen detection undergoing one-stage exchange for PJI of the hip. The authors put up the hypothesis that a preoperative pathogen detection is no prerequisite in selected cases undergoing one-stage exchange.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>30 consecutive patients with PJI of the hip, treated with one-stage exchange, between 2011 and 2021, were retrospectively included. Mean age was 70\u00a0years and mean follow-up 2.1\u2009\u00b1\u20091.8\u00a0years. PJI was defined according to the European Bone and Joint Infection Society. One-stage exchange was performed in (1) chronic PJI longer than 4\u00a0weeks, (2) well-retained bone condition, (3) absence of multiple prior revisions for PJI (\u2264\u20092) with absence of difficult-to-treat pathogens in the past, and (4) necessity\/preference for early mobility due to comorbidities\/age.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>One-stage exchange was performed in 20 patients with and in 10 without a preoperative pathogen detection. Age (71\u00a0years, 68\u00a0years, <jats:italic>p<\/jats:italic>\u2009=\u20090.519), sex (50% and 30% males, <jats:italic>p<\/jats:italic>\u2009=\u20090.440), American Society of Anesthesiologists Score (2.2, 2.4, <jats:italic>p<\/jats:italic>\u2009=\u20090.502), and Charlson Comorbidity Index (3, 4, <jats:italic>p<\/jats:italic>\u2009=\u20090.530) did not differ among the two groups. No significant differences were noted concerning preoperative CRP (15\u00a0mg\/l, 43\u00a0mg\/l, <jats:italic>p<\/jats:italic>\u2009=\u20090.228), synovial cell count (15.990\/nl, 5.308\/nl, <jats:italic>p<\/jats:italic>\u2009=\u20090.887), radiological signs of loosening (55%, 50%, <jats:italic>p<\/jats:italic>\u2009=\u20090.999), and intraoperative histopathology. Except a higher rate of coagulase-negative staphylococci (70%, 20%, <jats:italic>p<\/jats:italic>\u2009=\u20090.019) in patients with a preoperative pathogen detection, no significant differences in pathogen spectrum were identified among groups. Revision for PJI recurrence was performed in one patient with an initial preoperative pathogen detection (3.3%). Additional revisions were performed for dislocation in two and postoperative hematoma in one patient. Revision rate for both septic and aseptic causes (<jats:italic>p<\/jats:italic>\u2009=\u20090.999), stay in hospital (16 and 15\u00a0days, <jats:italic>p<\/jats:italic>\u2009=\u20090.373) and modified Harris Hip Score (60, 71, <jats:italic>p<\/jats:italic>\u2009=\u20090.350) did not differ between groups.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Patients with and without a preoperative pathogen detection did not show significant differences concerning baseline characteristics, clinical and functional outcomes at 2\u00a0years. An absent preoperative pathogen detection is no absolute contraindication for one-stage exchange in chronic PJI, if involving good bone quality and absence of multiple prior revisions.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00402-022-04459-5","type":"journal-article","created":{"date-parts":[[2022,5,4]],"date-time":"2022-05-04T16:03:57Z","timestamp":1651680237000},"page":"2823-2830","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Is a preoperative pathogen detection a prerequisite before undergoing one-stage exchange for prosthetic joint infection of the hip?"],"prefix":"10.1007","volume":"143","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7409-9002","authenticated-orcid":false,"given":"Daniel","family":"Karczewski","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yannick","family":"Seutz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Hipfl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Doruk","family":"Akg\u00fcn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Octavian","family":"Andronic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carsten","family":"Perka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Hardt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,5,4]]},"reference":[{"issue":"9","key":"4459_CR1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0139166","volume":"10","author":"SK Kunutsor","year":"2015","unstructured":"Kunutsor SK, Whitehouse MR, Blom AW, Beswick AD, INFORM Team (2015) Re-infection outcomes following one- and two-stage surgical revision of infected hip prosthesis: a systematic review and meta-analysis. 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