What Is the Most Reliable Concordance Rate of Preoperative Synovial Fluid Aspiration and Intraoperative Biopsy to Detect Periprosthetic Joint Infection in Knee, Hip and Shoulder Arthroplasty?
The accuracy of preoperative synovial fluid microbe detection in periprosthetic joint infection (PJI) is widely reported. However, the reliability of this diagnostic modality amongst the different joints is not yet described. We aimed to compare the concordance rate between preoperative synovial flu...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-09-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/12/10/1482 |
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| author | Mustafa Akkaya Luigi Zanna Rudy Sangaletti Ali Bokhari Thorsten Gehrke Mustafa Citak |
| author_facet | Mustafa Akkaya Luigi Zanna Rudy Sangaletti Ali Bokhari Thorsten Gehrke Mustafa Citak |
| author_sort | Mustafa Akkaya |
| collection | DOAJ |
| description | The accuracy of preoperative synovial fluid microbe detection in periprosthetic joint infection (PJI) is widely reported. However, the reliability of this diagnostic modality amongst the different joints is not yet described. We aimed to compare the concordance rate between preoperative synovial fluid and intraoperative tissue cultures in shoulder, knee and hip PJIs. A total of 150 patients who met the 2018 International Consensus Meeting criteria for shoulder, hip and knee PJI were retrospectively reviewed. This cohort was divided into three groups based on the involved joint (should, hip or knee), with 50 patients in each group. Cultures were collected and held for culture for 14 days. The overall concordance rate was 56.7%. Concordance rates between preoperative and intraoperative cultures were 60%, 56% and 54% for the knee, shoulder and hip joints, respectively. The analysis of high- or low-virulence and difficult- or not-difficult-to-treat germs did not reveal any significant differences between preoperative and intraoperative cultures in any of the groups. However, even considering the higher concordance in knee PJI, the overall discordance between preoperative and intraoperative cultures should prompt surgeons not to rely solely on preoperative synovial fluid culture data in determining appropriate treatment and antibiotics. |
| first_indexed | 2024-03-10T21:29:00Z |
| format | Article |
| id | doaj.art-0a490b277b324ed59871cd6eb14161e1 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-10T21:29:00Z |
| publishDate | 2023-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-0a490b277b324ed59871cd6eb14161e12023-11-19T15:26:06ZengMDPI AGAntibiotics2079-63822023-09-011210148210.3390/antibiotics12101482What Is the Most Reliable Concordance Rate of Preoperative Synovial Fluid Aspiration and Intraoperative Biopsy to Detect Periprosthetic Joint Infection in Knee, Hip and Shoulder Arthroplasty?Mustafa Akkaya0Luigi Zanna1Rudy Sangaletti2Ali Bokhari3Thorsten Gehrke4Mustafa Citak5Department of Orthopaedic Surgery, Helios ENDO-Klinik Hamburg, 22767 Hamburg, GermanyDepartment of Orthopaedic Surgery, Helios ENDO-Klinik Hamburg, 22767 Hamburg, GermanyDepartment of Orthopaedic Surgery, Helios ENDO-Klinik Hamburg, 22767 Hamburg, GermanyDepartment of Orthopaedic Surgery, Helios ENDO-Klinik Hamburg, 22767 Hamburg, GermanyDepartment of Orthopaedic Surgery, Helios ENDO-Klinik Hamburg, 22767 Hamburg, GermanyDepartment of Orthopaedic Surgery, Helios ENDO-Klinik Hamburg, 22767 Hamburg, GermanyThe accuracy of preoperative synovial fluid microbe detection in periprosthetic joint infection (PJI) is widely reported. However, the reliability of this diagnostic modality amongst the different joints is not yet described. We aimed to compare the concordance rate between preoperative synovial fluid and intraoperative tissue cultures in shoulder, knee and hip PJIs. A total of 150 patients who met the 2018 International Consensus Meeting criteria for shoulder, hip and knee PJI were retrospectively reviewed. This cohort was divided into three groups based on the involved joint (should, hip or knee), with 50 patients in each group. Cultures were collected and held for culture for 14 days. The overall concordance rate was 56.7%. Concordance rates between preoperative and intraoperative cultures were 60%, 56% and 54% for the knee, shoulder and hip joints, respectively. The analysis of high- or low-virulence and difficult- or not-difficult-to-treat germs did not reveal any significant differences between preoperative and intraoperative cultures in any of the groups. However, even considering the higher concordance in knee PJI, the overall discordance between preoperative and intraoperative cultures should prompt surgeons not to rely solely on preoperative synovial fluid culture data in determining appropriate treatment and antibiotics.https://www.mdpi.com/2079-6382/12/10/1482arthroplastyinfectionsynovial fluidintraoperative biopsy |
| spellingShingle | Mustafa Akkaya Luigi Zanna Rudy Sangaletti Ali Bokhari Thorsten Gehrke Mustafa Citak What Is the Most Reliable Concordance Rate of Preoperative Synovial Fluid Aspiration and Intraoperative Biopsy to Detect Periprosthetic Joint Infection in Knee, Hip and Shoulder Arthroplasty? Antibiotics arthroplasty infection synovial fluid intraoperative biopsy |
| title | What Is the Most Reliable Concordance Rate of Preoperative Synovial Fluid Aspiration and Intraoperative Biopsy to Detect Periprosthetic Joint Infection in Knee, Hip and Shoulder Arthroplasty? |
| title_full | What Is the Most Reliable Concordance Rate of Preoperative Synovial Fluid Aspiration and Intraoperative Biopsy to Detect Periprosthetic Joint Infection in Knee, Hip and Shoulder Arthroplasty? |
| title_fullStr | What Is the Most Reliable Concordance Rate of Preoperative Synovial Fluid Aspiration and Intraoperative Biopsy to Detect Periprosthetic Joint Infection in Knee, Hip and Shoulder Arthroplasty? |
| title_full_unstemmed | What Is the Most Reliable Concordance Rate of Preoperative Synovial Fluid Aspiration and Intraoperative Biopsy to Detect Periprosthetic Joint Infection in Knee, Hip and Shoulder Arthroplasty? |
| title_short | What Is the Most Reliable Concordance Rate of Preoperative Synovial Fluid Aspiration and Intraoperative Biopsy to Detect Periprosthetic Joint Infection in Knee, Hip and Shoulder Arthroplasty? |
| title_sort | what is the most reliable concordance rate of preoperative synovial fluid aspiration and intraoperative biopsy to detect periprosthetic joint infection in knee hip and shoulder arthroplasty |
| topic | arthroplasty infection synovial fluid intraoperative biopsy |
| url | https://www.mdpi.com/2079-6382/12/10/1482 |
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