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Diagnostic value of routine pre-operative investigations used in combination in the diagnosis of periprosthetic joint infection / Lucy C. Walker in Acta Orthopaedica Belgica, Vol.87/2 (Juin 2021)
[article]
Titre : Diagnostic value of routine pre-operative investigations used in combination in the diagnosis of periprosthetic joint infection Type de document : texte imprimé Auteurs : Lucy C. Walker ; Nick D. Clement ; Munawar Ashmi ; Julie Samuel ; David J. Deehan Année de publication : 2021 Article en page(s) : p. 374-381 Note générale : https://doi.org/10.52628/87.2.25 Langues : Anglais (eng) Mots-clés : Periprosthetic joint infection C-reactive protein (CRP) Erythrocyte sedimentation rate (ESR) joint aspiration diagnostic algorithm Résumé : The primary aim of this study was to assess the diagnostic accuracy of joint aspiration culture, serum C-reactive protein (CRP) and serum erythrocyte sedimentation rate (ESR), individually, and in combination for the diagnosis of periprosthetic joint infection (PJI).
A consecutive patient series with pre-operative inflammatory marker levels, an aspiration culture of either hip or knee arthroplasty and intra-operative culture samples from subsequent revision surgery was compiled. This retrospective patient cohort analysis included 128 aspiration. The data were analysed to compare pre-operative aspiration cultures, serum ESR and CRP levels to the chosen gold standard for PJI diagnosis of intra-operative culture samples. A diagnostic algorithm was created using the above tests combined with clinical suspicion index.
The values that had the highest sensitivity and specificity of predicting PJI were >5 for CRP and >16 for ESR. CRP used individually had the highest sensitivity and negative predictive value (NPV) of any test (75.0% and 75.9%, respectively). ESR + aspirate had the highest specificity and positive predictive value (PPV), of 100% for both. Using all three tests together the specificity and PPV were higher than the test individual values (95.3% and 85.0% respectively). Based on subgroup analyses the combination of ESR or CRP plus joint aspiration has superior PPV compared to individual tests. ESR and CRP had the highest NPV when used in isolation. An algorithm has been developed to guide clinical diagnosis.Permalink : ./index.php?lvl=notice_display&id=96675
in Acta Orthopaedica Belgica > Vol.87/2 (Juin 2021) . - p. 374-381[article] Diagnostic value of routine pre-operative investigations used in combination in the diagnosis of periprosthetic joint infection [texte imprimé] / Lucy C. Walker ; Nick D. Clement ; Munawar Ashmi ; Julie Samuel ; David J. Deehan . - 2021 . - p. 374-381.
https://doi.org/10.52628/87.2.25
Langues : Anglais (eng)
in Acta Orthopaedica Belgica > Vol.87/2 (Juin 2021) . - p. 374-381
Mots-clés : Periprosthetic joint infection C-reactive protein (CRP) Erythrocyte sedimentation rate (ESR) joint aspiration diagnostic algorithm Résumé : The primary aim of this study was to assess the diagnostic accuracy of joint aspiration culture, serum C-reactive protein (CRP) and serum erythrocyte sedimentation rate (ESR), individually, and in combination for the diagnosis of periprosthetic joint infection (PJI).
A consecutive patient series with pre-operative inflammatory marker levels, an aspiration culture of either hip or knee arthroplasty and intra-operative culture samples from subsequent revision surgery was compiled. This retrospective patient cohort analysis included 128 aspiration. The data were analysed to compare pre-operative aspiration cultures, serum ESR and CRP levels to the chosen gold standard for PJI diagnosis of intra-operative culture samples. A diagnostic algorithm was created using the above tests combined with clinical suspicion index.
The values that had the highest sensitivity and specificity of predicting PJI were >5 for CRP and >16 for ESR. CRP used individually had the highest sensitivity and negative predictive value (NPV) of any test (75.0% and 75.9%, respectively). ESR + aspirate had the highest specificity and positive predictive value (PPV), of 100% for both. Using all three tests together the specificity and PPV were higher than the test individual values (95.3% and 85.0% respectively). Based on subgroup analyses the combination of ESR or CRP plus joint aspiration has superior PPV compared to individual tests. ESR and CRP had the highest NPV when used in isolation. An algorithm has been developed to guide clinical diagnosis.Permalink : ./index.php?lvl=notice_display&id=96675 Exemplaires (1)
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Exclu du prêtThe role of serum D-dimer in the diagnosis of periprosthetic joint infection and timing of reimplantation / erden Sahim in Acta Orthopaedica Belgica, Vol. 87/4 (Décembre 2021)
[article]
Titre : The role of serum D-dimer in the diagnosis of periprosthetic joint infection and timing of reimplantation Type de document : texte imprimé Auteurs : erden Sahim ; Bedri Karaismailoglu ; Mahmut Kursat Ozsahim Année de publication : 2021 Article en page(s) : p. 587-592 Note générale : https://doi.org/10.52628/87.4.02 Langues : Anglais (eng) Mots-clés : periprosthetic joint infection diagnosis arthroplasty knee revision hip revision d-dimer Résumé : D-dimer is a fibrin degradation product formed by the destruction of the cross-linked fibrin clot by activation of the coagulation system. Many studies have shown that systemic and local infections cause fibrinolytic activities. The purpose of this study was to determine the role of serum D-dimer in the diagnosis of periprosthetic joint infection (PJI) and the timing of reimplantation. The patients who underwent primary and revision knee or hip arthroplasty between July 2018 and May 2019 were prospectively evaluated. All surgeries were performed by the same surgeon. 60 of 71 patients who met our criteria were included in the study, comprising of 27 primary arthroplasties (PA), 21 two-stage septic revision (SR) and 12 aseptic revision (AR). We analyzed D-dimer, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels. The values of the septic group were evaluated as two groups; Group 1 (before the first stage) and Group 2 (before the second stage) to investigate the role of D-dimer in determining the timing of reimplantation. D-dimer level was significantly higher in the SR group compared to PA and AR groups (p<0.001 and p=0.045). CRP and ESR levels were significantly higher in the SR group compared to PA and AR groups. There was no statistically significant difference between preoperative D-dimer levels of Group 1 and Group 2 (p=0.2). Serum D-dimer level can be used as an easy and inexpensive test to support the diagnosis of PJI. But the D-dimer level is not useful to determine the timing of reimplantation. Permalink : ./index.php?lvl=notice_display&id=102006
in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 587-592[article] The role of serum D-dimer in the diagnosis of periprosthetic joint infection and timing of reimplantation [texte imprimé] / erden Sahim ; Bedri Karaismailoglu ; Mahmut Kursat Ozsahim . - 2021 . - p. 587-592.
https://doi.org/10.52628/87.4.02
Langues : Anglais (eng)
in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 587-592
Mots-clés : periprosthetic joint infection diagnosis arthroplasty knee revision hip revision d-dimer Résumé : D-dimer is a fibrin degradation product formed by the destruction of the cross-linked fibrin clot by activation of the coagulation system. Many studies have shown that systemic and local infections cause fibrinolytic activities. The purpose of this study was to determine the role of serum D-dimer in the diagnosis of periprosthetic joint infection (PJI) and the timing of reimplantation. The patients who underwent primary and revision knee or hip arthroplasty between July 2018 and May 2019 were prospectively evaluated. All surgeries were performed by the same surgeon. 60 of 71 patients who met our criteria were included in the study, comprising of 27 primary arthroplasties (PA), 21 two-stage septic revision (SR) and 12 aseptic revision (AR). We analyzed D-dimer, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels. The values of the septic group were evaluated as two groups; Group 1 (before the first stage) and Group 2 (before the second stage) to investigate the role of D-dimer in determining the timing of reimplantation. D-dimer level was significantly higher in the SR group compared to PA and AR groups (p<0.001 and p=0.045). CRP and ESR levels were significantly higher in the SR group compared to PA and AR groups. There was no statistically significant difference between preoperative D-dimer levels of Group 1 and Group 2 (p=0.2). Serum D-dimer level can be used as an easy and inexpensive test to support the diagnosis of PJI. But the D-dimer level is not useful to determine the timing of reimplantation. Permalink : ./index.php?lvl=notice_display&id=102006 Réservation
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