Sensitivity and Specificity of Serum and Synovial Fluid Markers in Diagnosis of Infection in Head-Neck Taper Corrosion of Metal-On-Polyethylene Total Hip Arthroplasty |
| |
Institution: | 1. Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY;2. Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY;3. Institute for Healthcare Delivery Science, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY;1. Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA;2. Department of Orthopaedic Surgery, Newton-Wellesley Hospital, Newton, MA;3. Essex Orthopaedics and Sports Medicine, Salem, NH;4. Department of Orthopaedic Surgery, Lahey Hospital and Medical Center, Boston University School of Medicine, Burlington, MA;1. Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT;2. Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY;3. Weill Cornell Medical College, New York, NY;1. John A. Burns School of Medicine, Honolulu, HI;2. Bone and Joint Center, Straub Medical Center, Honolulu, HI;3. Department of Surgery, University of Hawai’i, Honolulu, HI |
| |
Abstract: | BackgroundThe accurate diagnosis of periprosthetic joint infection (PJI) in the setting of adverse local tissue reactions in patients with metal-on-polyethylene (MoP) total hip arthroplasty (THA) secondary to head-neck taper junction corrosion is challenging as it frequently has the appearance of purulence. The aim of this study is to evaluate the utility of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and synovial fluid markers in diagnosing PJI in failed MoP THA due to head-neck taper corrosion.MethodsA total of 89 consecutive patients with MoP THA with head-neck taper corrosion in 2 groups was evaluated: (1) infection group (n = 11) and (2) noninfection group (n = 78). All patients had highly crossed polyethylene with cobalt chromium femoral heads and had preoperative synovial fluid aspiration. In addition, serum cobalt and chromium levels were analyzed.ResultsThe optimal cutoff value for synovial white blood cell was 2144 with 93% sensitivity and 84% specificity. Neutrophil count optimal cutoff value was 82% with 93% sensitivity and 82% specificity. Receiver operating characteristic analysis of ESR and CRP determined optimal cutoff at 57 mm/h and 35 mg/L with 57% sensitivity and 94% specificity and 93% sensitivity and 76% specificity, respectively. There were no significant differences in metal ion levels between the infected and noninfected groups.ConclusionThe results of this study suggest that ESR and CRP are useful in excluding PJI, whereas both synovial white blood cell count and neutrophil percentage in hip aspirate are useful markers for diagnosing infection in MoP THA patients with head-neck taper corrosion associated adverse local tissue reaction. |
| |
Keywords: | adverse local tissue reaction periprosthetic joint infection head-neck taper corrosion cobalt and chromium metal ion level metal-on-polyethylene total hip arthroplasty |
本文献已被 ScienceDirect 等数据库收录! |
|