title: Preoperative diagnostic for periprosthetic joint infection prior to total knee revision arthroplasty.
abstract: Periprosthetic joint infection (PJI) after total knee arthroplasty remains a challenging problem. The aim of this study was to evaluate the accuracy of diagnostic knee aspiration and serum inflammatory markers in diagnostic of a PJI after total knee arthroplasty. Within 2011 and 2012, 46 patients received a one- or two-stage revision arthroplasty of the knee joint. These patients received a total number of 77 operations. A preoperative aspiration was performed in each case. We analyzed the microbiological and histological examinations of the samples from the aspiration and from the revision operation and additionally estimated serum inflammatory markers. The diagnostic aspiration had a specificity of 0.87, a sensitivity of 0.39, a positive predictive value of 0.67 and a negative predictive value of 0.68. For C-reactive protein the specificity was 0.61 and the sensitivity was 0.48, the serum white blood cell count had a specificity of 0.98 and a sensitivity of 0.23. Our data queries whether diagnostic joint aspiration or serum inflammatory markers are sufficient to verify or exclude a PJI.
authors.affiliation: Orthopedic Department, Hannover Medical School , Germany.
authors.forename: Leif
authors.initials: L
authors.lastname: Claassen
authors.affiliation: Orthopedic Department, Hannover Medical School , Germany.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Radtke
authors.affiliation: Orthopedic Department, Hannover Medical School , Germany.
authors.forename: Max
authors.initials: M
authors.lastname: Ettinger
authors.affiliation: Orthopedic Department, Hannover Medical School , Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Plaass
authors.affiliation: Orthopedic Department, Hannover Medical School , Germany.
authors.forename: Gabriela
authors.initials: G
authors.lastname: von Lewinski
keywords: diagnostic aspiration; periprosthetic joint infection; serum inflammatory marker; total joint arthroplasty