The role of intraoperative frozen section in decision making in revision hip and knee arthroplasties in a local community hospital.

There is little information in the literature regarding the reliability of intraoperative frozen section to predict infection in revision arthroplasties performed in community hospitals as most reports are from specialized centers or academic institutes. Between November 1997 and May 2001, we performed intraoperative frozen sections in 40 revision hip and knee arthroplasties. We used Mirra's criteria of more than 5 polymorphs per high power field to constitute a positive result. We found a sensitivity of 67% and a specificity of 97%. The positive and negative predictive values were 86% and 91%, respectively, with an accuracy of 90%. We conclude that intraoperative frozen section is a reasonably sensitive and specific adjunct investigation in the differentiation between septic and aseptic loosening.