The value of hip aspiration versus tissue biopsy in diagnosing infection before exchange hip arthroplasty surgery

被引:66
作者
Williams, JL
Norman, P
Stockley, I
机构
[1] No Gen Hosp, Dept Orthopaed, Sheffield S5 7AU, S Yorkshire, England
[2] No Gen Hosp, Dept Microbiol, Sheffield S5 7AU, S Yorkshire, England
关键词
infection; aspiration; tissue biopsy; hip arthroplasty;
D O I
10.1016/j.arth.2003.11.011
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
摘要
The exclusion of infection is the most important factor in determining treatment options in a failed hip arthroplasty. Preoperative biopsy in the form of aspiration or tissue biopsy can be used to diagnose infection. Preoperative aspiration and tissue drill biopsy were performed in 273 consecutive patients under general anesthesia 3 months before exchange arthroplasty surgery. The results of the preoperative aspiration and tissue biopsy cultures were compared with the definitive intraoperative tissue cultures obtained at surgery. Seventy-one of 273 (26%) hips were infected. Overall accuracy of aspiration was 90.1% and tissue biopsy 87.9%. The sensitivity and specificity was 80% and 94% for aspiration and 83% and 90% for tissue biopsy. Positive predictive value and negative predictive values were 81.4% and 93.1% for aspiration and 73.8% and 93.8% for tissue biopsy. The more invasive tissue drill biopsy offers no advantage over aspiration in terms of bacterial accuracy and results in more false positives. (C) 2004 Elsevier Inc. All rights reserved.
引用
收藏
页码:582 / 586
页数:5
相关论文
共 30 条
[1]
AALTO K, 1984, CLIN ORTHOP RELAT R, V184, P118
[2]
THE VALUE OF ASPIRATION OF THE HIP-JOINT BEFORE REVISION TOTAL HIP-ARTHROPLASTY [J].
BARRACK, RL ;
HARRIS, WH .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1993, 75A (01) :66-76
[3]
THE USE OF BONE ALLOGRAFTS IN 2-STAGE RECONSTRUCTION AFTER FAILURE OF HIP REPLACEMENTS DUE TO INFECTION [J].
BERRY, DJ ;
CHANDLER, HP ;
REILLY, DT .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1991, 73A (10) :1460-1468
[4]
MANAGEMENT OF DEEP INFECTION OF TOTAL HIP-REPLACEMENT [J].
BUCHHOLZ, HW ;
ELSON, RA ;
ENGELBRECHT, E ;
LODENKAMPER, H ;
ROTTGER, J ;
SIEGEL, A .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 1981, 63 (03) :342-353
[5]
THE INFECTED HIP AFTER TOTAL HIP-ARTHROPLASTY [J].
CANNER, GC ;
STEINBERG, ME ;
HEPPENSTALL, RB ;
BALDERSTON, R .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1984, 66A (09) :1393-1399
[6]
CLINICAL-SIGNIFICANCE OF THE ERYTHROCYTE SEDIMENTATION-RATE IN ORTHOPEDIC-SURGERY [J].
COVEY, DC ;
ALBRIGHT, JA .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1987, 69A (01) :148-151
[7]
ELSON RA, 1993, ORTHOP CLIN N AM, V24, P761
[8]
Aspiration as a guide to sepsis in revision total hip arthroplasty [J].
Fehring, TK ;
Cohen, B .
JOURNAL OF ARTHROPLASTY, 1996, 11 (05) :543-547
[9]
CURRENT CONCEPTS REVIEW INFECTION AFTER TOTAL HIP-ARTHROPLASTY PAST, PRESENT, AND FUTURE [J].
GARVIN, KL ;
HANSSEN, AD .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1995, 77 (10) :1576-1588
[10]
Evaluation and treatment of infection at the site of a total hip of knee arthroplasty [J].
Hanssen, AD ;
Rand, JA .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1998, 80A (06) :910-922