Utility of Synovial Fluid Aspirations in Failed Metal-On-Metal Total Hip Arthroplasty

被引：63

作者：

Wyles, Cody C. ^{[1
]}

Larson, Dirk R. ^{[1
]}

Houdek, Matthew T. ^{[1
]}

Sierra, Rafael J. ^{[1
]}

Trousdale, Robert T. ^{[1
]}

机构：

[1] Mayo Clin, 200 1st St SW, Rochester, MN 55905 USA

来源：

JOURNAL OF ARTHROPLASTY | 2013年 / 28卷 / 05期

关键词：

aspiration; total hip arthroplasty; PERIPROSTHETIC JOINT INFECTION; INTRAOPERATIVE FROZEN-SECTION; REVISION HIP; DIAGNOSIS; MARKERS; INTERLEUKIN-6; PROSTHESIS; MIMICKING; FAILURE; SEPSIS;

D O I：

10.1016/j.arth.2012.11.006

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

100224 [整形外科学];

摘要：

White blood cell (WBC) count and neutrophil percentage from preoperative synovial fluid aspirations are used to help determine the presence or absence of periprosthetic joint infection (PJI) in failed total hip arthroplasty (THA). The clinical levels indicative of infection have not been delineated in metal-on-metal (MOM) bearings. We identified 39 patients who received a preoperative synovial fluid aspiration prior to MoM revision. Thirty-five of 39 cases were culture negative and 4 of 39 were culture positive. WBC count >3000 cells/mu L was 100% sensitive and 57.1% specific. Neutrophil percentage >80% was 100% sensitive and 97.1% specific. Both CRP and ESR >8.0 mg/L and >22 mm/h, respectively were 75.0% sensitive and 67.6% specific. Our data suggest that synovial WBC count and serum ESR and CRP have poor predictive value in diagnosing PJI for failed MoM THA, whereas synovial neutrophil percentage is a highly accurate marker for diagnosing infection in this patient population. (C) 2013 Elsevier Inc. All rights reserved.

引用

页码：818 / 823

页数：6

共 42 条

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