Forschungsdatenbank PMU-SQQUID

PMU-Autor/inn/en

Abstract

Preoperative diagnosis of periprosthetic joint infection (PJI) is important because of the therapeutic consequences. This prospective study was designed to answer the question, if preoperative PCR analysis of the synovial fluid in addition to the culture and the CRP analysis of the blood are helpful for the diagnosis of PJI in knee arthroplasties. Before revision CRP analysis of the blood, cultivation and PCR analysis of synovial fluid of 116 knee endoprostheses were performed. During revision surgery, five tissue samples of the periprosthetic tissue were cultured and five further samples subjected to histological analysis. These analyses of the periprosthetic tissue were used to verify the results of the preoperative diagnostic methods. Twenty-seven prostheses were identified as infected (prevalence 23.3%). The combined analyses of the joint fluid cultivation and the CRP blood level resulted in a sensitivity of 77.8%, a specificity of 95.5%, a positive-predictive value of 84.0%, a negative-predictive value of 93.4% and an accuracy of 91.4%. The PCR analysis of the synovial fluid resulted in a sensitivity of 55.6%, a specificity of 82.0%, a positive-predictive value of 48.4%, a negative-predictive value of 85.9% and an accuracy of 75.9%. The sensitivity for culture of the aspirate and PCR analysis in combination with an elevated CRP level was 85.2%, the specificity 82.0%, the positive-predictive value 58.9%, the negative-predictive value 94.8% and the accuracy 82.7%. The preoperative PCR analysis of synovial fluid has only limited value in addition to the standard culture analysis.

Useful keywords (using NLM MeSH Indexing)

Adult

Aged

Aged, 80 and over

Arthroplasty, Replacement, Knee/adverse effects*

C-Reactive Protein/analysis

Female

Humans

Knee Joint/microbiology

Knee Joint/surgery

Male

Middle Aged

Polymerase Chain Reaction*

Preoperative Care

Prospective Studies

Prosthesis-Related Infections/diagnosis*

Prosthesis-Related Infections/etiology

Prosthesis-Related Infections/surgery

Reoperation

Synovial Fluid/microbiology*

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