The 2018 International Consensus Meeting Minor Criteria for Chronic Hip and Knee Periprosthetic Joint Infection: Validation From a Single Center |
| |
| Affiliation: | 1. Department of Orthopaedic Surgery, Helios ENDO-Klinik, Hamburg, Germany;2. Department of Surgery, Ruhr-University Hospital, Bochum, Germany;3. Department of Trauma and Reconstructive Surgery, Ludwig-Maximilians-University, Munich, Germany;1. Department of Orthopaedic Surgery, Lenox Hill Hospital, Northwell Health, New York, NY;2. Department of Orthopaedic Surgery, Cleveland Clinic Cleveland, OH;3. Department of Orthopaedic Surgery, SUNY Downstate Brooklyn, New York, NY;4. Department of Orthopaedic Surgery, Johns Hopkins Medical Center Baltimore, MD |
| |
| Abstract: | BackgroundRecently, a revised definition of the minor criteria scoring system for diagnosing periprosthetic joint infection (PJI) was developed by the second International Consensus Meeting on musculoskeletal infection. The new system combines preoperative and intraoperative findings, reportedly achieving high sensitivity and specificity. We aimed to validate the modified scoring system at a high-volume center.MethodsWe retrospectively reviewed patients who underwent a revision total hip or knee arthroplasty at our institution from May 2015 to August 2018. Serum C-reactive protein, synovial white blood cell count and polymorphonuclear percentage, leukocyte esterase test, alpha-defensin, microbiological and histologic results, and documented existence of sinus tract and intraoperative purulence were available for all patients. Cases with at least 1 major criterion were considered as infected. Using the new minor criteria, a score of ≥6 reflects PJI, while a score <3 can be considered as noninfected. Sensitivity, specificity, mean accuracy (ACC), positive predictive value (PPV), and negative predictive value (NPV) were analyzed.ResultsA total of 345 cases were included. A cutoff score of ≥6 points had the following diagnostic performance: area under the curve (AUC) = 0.90; ACC = 0.88; sensitivity = 0.96; specificity = 0.84; PPV = 0.70; NPV = 0.98. Diagnostic performance was better for the hip (AUC = 0.92; ACC = 0.90; sensitivity = 0.96; specificity = 0.86; PPV = 0.81; NPV = 0.98) than the knee (AUC = 0.89; ACC = 0.85; sensitivity = 0.95; specificity = 0.83; PPV = 0.59; NPV = 0.98).ConclusionThe modified scoring system proposed by the 2018 International Consensus Meeting in diagnosing PJI showed high sensitivity and a good performance, especially as rule-out diagnostic criteria. The cutoff level seems to be different between the hip and knee. Further validation studies considering the acknowledged limitations are recommended. |
| |
| Keywords: | total hip arthroplasty total knee arthroplasty periprosthetic joint infection minor criteria international consensus meeting validation |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
