title: Usefulness of histology for predicting infection at the time of hip revision for the treatment of Vancouver B2 periprosthetic fractures.
abstract: When facing a Vancouver B2 periprosthetic fracture, the most recommended treatment is the prosthesis replacement. Current tests do not provide enough reliability to identify whether the fracture has been produced on a septic or an aseptic loosened prosthesis. Our aim was to evaluate the usefulness of the histology for the diagnosis of infection in these cases. A total of 11 hip revision procedures were performed (mean age: 78.1 years, 8 women and 3 men). Sensitivity, specificity, positive predictive value and negative predictive value of the histology were 100%, 55.5%, 33.3% and 100% respectively. Of the six patients presenting with a positive histology, four of them had negative cultures (66.6% of false positives). Our results suggest that periprosthetic fractures are a cause of false-positive histology results for the diagnosis of infection during revision of a hip prosthesis for the treatment of Vancouver B2 periprosthetic fractures.
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Hospital Clínic of Barcelona, University of Barcelona, Barcelona, Spain.
authors.forename: Ernesto
authors.initials: E
authors.lastname: Muñoz-Mahamud
authors.forename: Guillem
authors.initials: G
authors.lastname: Bori
authors.forename: Sebastián
authors.initials: S
authors.lastname: García
authors.forename: José
authors.initials: J
authors.lastname: Ramírez
authors.forename: Josep
authors.initials: J
authors.lastname: Riba
authors.forename: Alejandro
authors.initials: A
authors.lastname: Soriano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D005189:False Positive Reactions; D005260:Female; D005269:Femur / Q000382:microbiology / Q000473:pathology*; D006652:Histological Techniques / Q000379:methods*; D006801:Humans; D008297:Male; D008828:Microbiological Techniques; D008875:Middle Aged; D057068:Periprosthetic Fractures / Q000145:classification / Q000601:surgery*; D011237:Predictive Value of Tests; D016459:Prosthesis-Related Infections / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology*; D012086:Reoperation; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
keywords: arthroplasty; cultures; hip; histology; infection; periprosthetic fractures