title: Ten versus five polymorphonuclear leukocytes as threshold in frozen section tests for periprosthetic infection: a meta-analysis.
abstract: We objectively appraised available evidence regarding the threshold for the number of polymorphonuclear leukocytes required in frozen section tests used to diagnose periprosthetic infection. Pooled summary estimates for sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio (OR) were compared for ten and five polymorphonuclear leukocytes per high power field as the threshold. The total cohort included 1011 patients and the rate of infection was 19.2%. Although there was no difference in sensitivity or diagnostic OR, specificity was significantly higher for ten than for five polymorphonuclear leukocytes per high power field (p=0.007) In sum, a threshold of 10 polymorphonuclear leukocytes is better for diagnosing periprosthetic infections.
authors.affiliation: Department of Orthopedic Surgery, The Second Affiliated Hospital, Medical College of Zhejiang University, Hangzhou 310009, China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Zhao
authors.forename: Chao
authors.initials: C
authors.lastname: Guo
authors.forename: Gang-Sheng
authors.initials: GS
authors.lastname: Zhao
authors.forename: Tiao
authors.initials: T
authors.lastname: Lin
authors.forename: Zhong-Li
authors.initials: ZL
authors.lastname: Shi
authors.forename: Shi-Gui
authors.initials: SG
authors.lastname: Yan
mesh_terms: D005629:Frozen Sections; D006801:Humans; D009504:Neutrophils; D016459:Prosthesis-Related Infections / Q000473:pathology*; D015203:Reproducibility of Results