Reliability of intra-operative frozen section study in revision of infected hip arthroplasty
Abstract Introduction Frozen sections are extensively used to help in the diagnosis of periprosthetic joint infection during revision hip arthroplasty, though there are insufficient data in relation to its usefulness. Methods Twenty-one patients with infected hip arthroplasties were operated in the...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-12-01
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| Series: | Arthroplasty |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s42836-019-0016-2 |
| _version_ | 1819071561617899520 |
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| author | Karan Doshi Deepesh Daultani M. Ajith Kumar Shantharam Shetty Shailesh Pai |
| author_facet | Karan Doshi Deepesh Daultani M. Ajith Kumar Shantharam Shetty Shailesh Pai |
| author_sort | Karan Doshi |
| collection | DOAJ |
| description | Abstract Introduction Frozen sections are extensively used to help in the diagnosis of periprosthetic joint infection during revision hip arthroplasty, though there are insufficient data in relation to its usefulness. Methods Twenty-one patients with infected hip arthroplasties were operated in the form of one or two-staged revision hip arthroplasties. A frozen section was obtained intra-operatively and > 5 PMN’s/ HPF was considered as a positive indicator of infection. If the frozen section was reported negative (≤5 PMN’s/HPF), the revision prosthesis was implanted after a thorough debridement and a wash. If the frozen section was reported as positive, post the debridement; a non-articulating antibiotic-loaded cement spacer was implanted for 8 weeks, supplemented with 3 weeks of intravenous antibiotics and 3 weeks of oral antibiotics. This was followed by an antibiotic-free interval of 2 weeks. The patient was taken up for a revision surgery once the frozen section study was negative (≤5 PMN’s/HPF). The patients were followed up for a minimum of 1 year to a maximum of 2 years after the revision for any evidence of infection (assessed clinically, serologically, and radiologically). Results Frozen section analysis of PMNs per high power field had a 100% specificity in our patients in detecting periprosthetic joint infection. Conclusion Frozen section study is a safe, rapid, cheap and reliable intra-operative modality to diagnose periprosthetic joint infection. |
| first_indexed | 2024-12-21T17:23:48Z |
| format | Article |
| id | doaj.art-aa25ab29edaf4a49bfc829c2a5474a70 |
| institution | Directory Open Access Journal |
| issn | 2524-7948 |
| language | English |
| last_indexed | 2024-12-21T17:23:48Z |
| publishDate | 2019-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Arthroplasty |
| spelling | doaj.art-aa25ab29edaf4a49bfc829c2a5474a702022-12-21T18:56:06ZengBMCArthroplasty2524-79482019-12-01111610.1186/s42836-019-0016-2Reliability of intra-operative frozen section study in revision of infected hip arthroplastyKaran Doshi0Deepesh Daultani1M. Ajith Kumar2Shantharam Shetty3Shailesh Pai4Tejasvini Hospital & SSIOTTejasvini Hospital & SSIOTTejasvini Hospital & SSIOTTejasvini Hospital & SSIOTTejasvini Hospital & SSIOTAbstract Introduction Frozen sections are extensively used to help in the diagnosis of periprosthetic joint infection during revision hip arthroplasty, though there are insufficient data in relation to its usefulness. Methods Twenty-one patients with infected hip arthroplasties were operated in the form of one or two-staged revision hip arthroplasties. A frozen section was obtained intra-operatively and > 5 PMN’s/ HPF was considered as a positive indicator of infection. If the frozen section was reported negative (≤5 PMN’s/HPF), the revision prosthesis was implanted after a thorough debridement and a wash. If the frozen section was reported as positive, post the debridement; a non-articulating antibiotic-loaded cement spacer was implanted for 8 weeks, supplemented with 3 weeks of intravenous antibiotics and 3 weeks of oral antibiotics. This was followed by an antibiotic-free interval of 2 weeks. The patient was taken up for a revision surgery once the frozen section study was negative (≤5 PMN’s/HPF). The patients were followed up for a minimum of 1 year to a maximum of 2 years after the revision for any evidence of infection (assessed clinically, serologically, and radiologically). Results Frozen section analysis of PMNs per high power field had a 100% specificity in our patients in detecting periprosthetic joint infection. Conclusion Frozen section study is a safe, rapid, cheap and reliable intra-operative modality to diagnose periprosthetic joint infection.https://doi.org/10.1186/s42836-019-0016-2InfectionArthroplastyHipFrozen sections |
| spellingShingle | Karan Doshi Deepesh Daultani M. Ajith Kumar Shantharam Shetty Shailesh Pai Reliability of intra-operative frozen section study in revision of infected hip arthroplasty Arthroplasty Infection Arthroplasty Hip Frozen sections |
| title | Reliability of intra-operative frozen section study in revision of infected hip arthroplasty |
| title_full | Reliability of intra-operative frozen section study in revision of infected hip arthroplasty |
| title_fullStr | Reliability of intra-operative frozen section study in revision of infected hip arthroplasty |
| title_full_unstemmed | Reliability of intra-operative frozen section study in revision of infected hip arthroplasty |
| title_short | Reliability of intra-operative frozen section study in revision of infected hip arthroplasty |
| title_sort | reliability of intra operative frozen section study in revision of infected hip arthroplasty |
| topic | Infection Arthroplasty Hip Frozen sections |
| url | https://doi.org/10.1186/s42836-019-0016-2 |
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