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Microbial Colonization of Capsular Traction Sutures in Hip Arthroscopic Surgery
Ian S Patten1, Yuhang Sun1, David R Maldonado1
1Cedars-Sinai Kerlan-Jobe Institute, Los Angeles, California, USA.
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.
Insights
Microbial colonization of hip arthroscopy sutures is rare (0.5%), with no identified patient risk factors. These capsular traction sutures can be safely incorporated into repairs, minimizing joint contamination risk.
Area of Science:
- Orthopedic Surgery
- Microbiology
- Surgical Innovation
Background:
- Capsular traction sutures are commonly used in hip arthroscopic surgery.
- These sutures may introduce microbial contamination into the hip joint upon incorporation into the repair site.
Purpose of the Study:
- To determine the microbial colonization rate of capsular traction sutures.
- To identify patient-specific risk factors associated with this colonization.
Main Methods:
- A cross-sectional study analyzed 50 patients undergoing hip arthroscopy.
- 200 traction sutures and 50 control sutures were cultured for aerobic and non-aerobic bacteria.
- Patient demographics and traction time were assessed for risk factor analysis.
Main Results:
- A low microbial colonization rate of 0.5% was observed.
- Proteus mirabilis and Citrobacter koseri were identified in positive cultures from one patient.
- No significant association was found between patient age, traction time, and positive cultures.
Conclusions:
- Capsular traction sutures show a low rate of microbial colonization in hip arthroscopic surgery.
- No patient-associated risk factors for colonization were identified.
- Incorporating these sutures into capsular closure presents a minimal risk of joint seeding.
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