We have located links that may give you full text access.
Intra-operative diagnosis of periprosthetic joint infection can rely on frozen sections in patients without synovial fluid analyses.
International Orthopaedics 2019 June
BACKGROUND: The purpose of this study was to determine whether frozen sections can increase diagnostic values of serological tests for the assessment of periprosthetic joint infection (PJI) in patients without synovial fluid analyses.
METHODS: A retrospective review of 128 revision arthroplasties (79 hips and 49 knees) from January 2016 to December 2017 was performed. Diagnosis of PJI was based on the Musculoskeletal Infection Society criteria for infection. Three diagnostic models for PJI, with model 1 including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), model 2 including model 1 plus frozen sections > 5 polymorphonuclear neutrophil (PMN)s per high-power field (HPF), and model 3 including model 1 plus frozen sections > 10 PMNs per HPF, were developed. Then receiver operating characteristic (ROC) curves were generated, and the areas under the ROC curves (AUCs) were compared.
RESULTS: The AUC of model 1, model 2, and model 3 was 79.40% [95% confidence interval (CI), 69.84 to 86.64%], 89.30% (95% CI, 82.93 to 93.92%), and 85.52% (95% CI, 78.44 to 91.4%), respectively. The AUC of model 1 was significantly lower than that of model 2 (p = 0.002) and model 3 (p = 0.039). Although the result was not significant (p = 0.132), there was a trend toward a higher AUC of model 2 than model 3.
CONCLUSIONS: This study reveals that intra-operative frozen sections significantly increased the performance of serum ESR and CRP in the diagnosis of PJI. The combination of serological tests and frozen sections for the assessment of PJI may be reliable in patients without synovial fluid analyses.
METHODS: A retrospective review of 128 revision arthroplasties (79 hips and 49 knees) from January 2016 to December 2017 was performed. Diagnosis of PJI was based on the Musculoskeletal Infection Society criteria for infection. Three diagnostic models for PJI, with model 1 including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), model 2 including model 1 plus frozen sections > 5 polymorphonuclear neutrophil (PMN)s per high-power field (HPF), and model 3 including model 1 plus frozen sections > 10 PMNs per HPF, were developed. Then receiver operating characteristic (ROC) curves were generated, and the areas under the ROC curves (AUCs) were compared.
RESULTS: The AUC of model 1, model 2, and model 3 was 79.40% [95% confidence interval (CI), 69.84 to 86.64%], 89.30% (95% CI, 82.93 to 93.92%), and 85.52% (95% CI, 78.44 to 91.4%), respectively. The AUC of model 1 was significantly lower than that of model 2 (p = 0.002) and model 3 (p = 0.039). Although the result was not significant (p = 0.132), there was a trend toward a higher AUC of model 2 than model 3.
CONCLUSIONS: This study reveals that intra-operative frozen sections significantly increased the performance of serum ESR and CRP in the diagnosis of PJI. The combination of serological tests and frozen sections for the assessment of PJI may be reliable in patients without synovial fluid analyses.
Full text links
Related Resources
Trending Papers
Heart failure with preserved ejection fraction: diagnosis, risk assessment, and treatment.Clinical Research in Cardiology : Official Journal of the German Cardiac Society 2024 April 12
Proximal versus distal diuretics in congestive heart failure.Nephrology, Dialysis, Transplantation 2024 Februrary 30
Efficacy and safety of pharmacotherapy in chronic insomnia: A review of clinical guidelines and case reports.Mental Health Clinician 2023 October
World Health Organization and International Consensus Classification of eosinophilic disorders: 2024 update on diagnosis, risk stratification, and management.American Journal of Hematology 2024 March 30
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app