title: Correlation of aspiration results with periprosthetic sepsis in revision total hip arthroplasty.
abstract: A retrospective chart review was performed of all patients who had undergone revision total hip arthroplasty with a synovial aspiration with greater than 100 WBC since the institution of our electronic medical record. Infection was defined using a combination of criteria. A diagnosis of periprosthetic sepsis was established in 52 of the 253 included hips. No significant differences existed with respect to gender, age, BMI, Deyo-Charlson Comorbidity Index, or the cause of initial hip degeneration. Using receiver-operating characteristic curves accuracy was maximized for WBC of 745 or segmented cell count of 73.5% with a sensitivity of 98%, specificity of 37%, negative predictive value of 99% and accuracy of 50%. Application of the current American Academy of Orthopaedic Surgery Clinical Practice Guidelines (AAOS CPG) thresholds revealed a similar accuracy of 49%.
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois.
authors.forename: Peter N
authors.initials: PN
authors.lastname: Chalmers
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois.
authors.forename: Scott M
authors.initials: SM
authors.lastname: Sporer
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois.
authors.forename: Brett R
authors.initials: BR
authors.lastname: Levine
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D005260:Female; D006621:Hip Joint / Q000473:pathology* / Q000601:surgery; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016459:Prosthesis-Related Infections / Q000175:diagnosis*; D012086:Reoperation; D012189:Retrospective Studies; D013396:Suction; D013582:Synovial Fluid / Q000166:cytology*
keywords: hip arthroplasty; infection; periprosthetic sepsis; revision hip arthroplasty; synovial aspiration