Articles Vol. 67 No. Số CĐ12- Bệnh viện Ung bướu Nghệ An (2026) 25/08/2026

APPLICATION OF INTRAOPERATIVE FROZEN SECTION IN SECOND-STAGE REIMPLANTATION FOR CHRONIC PERIPROSTHETIC HIP JOINT INFECTION

Le Van Tuan1,2, Tran Binh Duong3,4, Truong Nguyen Khanh Hung3,4, Dao Thanh Tu3,4,5,6
1 Tam Anh General Hospital, Ho Chi Minh City
2 Bệnh viện Đa khoa Tâm Anh Thành phố Hồ Chí Minh
3 Cho Ray Hospital
4 Bệnh viện Chợ Rẫy
5 University of Medicine and Pharmacy at Ho Chi Minh City
6 Đại học Y Dược thành phố Hồ Chí Minh
DOI: 10.52163/yhc.v67iCD12.6275
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Keywords
Frozen section; periprosthetic joint infection; two-stage revision; reinfection.
Abstract

Objective: To describe the application of intraoperative frozen section (FS) and analyze its association with reinfection in second-stage revision arthroplasty for patients with chronic periprosthetic hip joint infection.

Materials and Methods: A prospective case series study was conducted on 39 patients with chronic PJI who underwent two-stage revision arthroplasty at Cho Ray Hospital between January 2021 and November 2025. FS was routinely performed during the second stage using five periprosthetic tissue samples, with a negative threshold defined as <5 polymorphonuclear neutrophils per high-power field (x400).

Results: The mean age was 51.2 years, and 69.2% of patients were male. Positive bacterial cultures were identified in 74.36% of cases, with methicillin-resistant Staphylococcus aureus (MRSA) being the most common pathogen (41.03%). Positive FS results were observed in 5/39 cases (12.8%). The mean turnaround time for FS results was 40.72 ± 6.6 minutes. After a mean follow-up of 26.9 months, the success rate reached 94.9%. Positive FS results were significantly associated with postoperative reinfection (p = 0.013).

Conclusion: Intraoperative frozen section may immediately provide useful information for assessing persistent infection during second-stage reimplantation. FS should be integrated with clinical findings and serological tests to optimize surgical decision-making.

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