Back to Search
Start Over
Diagnosis of Chronic Infection at Total Hip Arthroplasty Revision Is a Question of Definition.
- Source :
-
BioMed research international [Biomed Res Int] 2021 Nov 19; Vol. 2021, pp. 8442435. Date of Electronic Publication: 2021 Nov 19 (Print Publication: 2021). - Publication Year :
- 2021
-
Abstract
- Purpose: Contradicting definitions of periprosthetic joint infection (PJI) are in use. Joint aspiration is performed before total hip arthroplasty (THA) revision. This study investigated the influence of PJI definition on PJI prevalence at THA revision. Test quality of prerevision aspiration was evaluated for the different PJI definitions.<br />Methods: 256 THA revisions were retrospectively classified to be infected or not infected. Classification was performed according to the 4 different definitions proposed by the Musculoskeletal Infection Society (MSIS), the Infectious Diseases Society of America (IDSA), the International Consensus Meeting (ICM), and the European Bone and Joint Infection Society (EBJIS). Only chronic PJIs were included.<br />Results: PJI prevalence at revision significantly correlated with the applied PJI definition ( p = 0.01, Cramer's V = 0.093). PJI prevalence was 20.7% for the MSIS, 25.4% for the ICM, 28.1% for the IDSA, and 32.0% for the EBJIS definition. For synovial fluid white blood cell count, the best ROC-AUC for predicting PJI was 0.953 in combination with the MSIS definition.<br />Conclusion: PJI definition significantly influences the rate of diagnosed PJIs at THA revision. Synovial fluid white blood cell count is a reliable means to rule out PJI. In cases with a borderline high synovial white blood cell count before THA revision as the only sign of chronic PJI, an extended diagnostic work-up should be considered.<br />Competing Interests: No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.<br /> (Copyright © 2021 Sebastian Philipp Boelch et al.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Arthritis, Infectious diagnosis
Arthritis, Infectious epidemiology
Arthritis, Infectious etiology
Chronic Disease
Female
Germany
Hip Prosthesis adverse effects
Hip Prosthesis microbiology
Humans
Leukocyte Count
Male
Middle Aged
Paracentesis
Prevalence
Prosthesis-Related Infections epidemiology
Prosthesis-Related Infections etiology
Retrospective Studies
Synovial Fluid cytology
Synovial Fluid microbiology
Young Adult
Arthroplasty, Replacement, Hip adverse effects
Prosthesis-Related Infections diagnosis
Reoperation adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 2314-6141
- Volume :
- 2021
- Database :
- MEDLINE
- Journal :
- BioMed research international
- Publication Type :
- Academic Journal
- Accession number :
- 34840982
- Full Text :
- https://doi.org/10.1155/2021/8442435