BACKGROUND: Diagnosis of periprosthetic joint infection (PJI) remains a challenge despite a wide variety of available diagnostic tests. The question that arises is which of these tests has a better performance for diagnosing PJI. Diagnostic odds ratio (DOR) has been described as the best indicator for test performance. METHODS: To compare the performance of the standard diagnostic tests, the DOR of serum erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), synovial fluid (SF) white blood cell (WBC) count, SF polymorphonuclear (PMN%), and leukocyte esterase (LE) were calculated. RESULTS: We obtained 4662 ESRs, 4392 CRPs, 836 SF WBC, 804 SF PMN%, and 659 LE results. LE had the highest DOR for diagnosing PJI: 30.06 (95% confidence interval [CI]: 17.8-50.7). The rest of the DORs in the descending order were SF WBC: 29.4 (95% CI: 20.2-42.8), CRP: 25.6 (95% CI: 19.5-33.7), SF PMN%: 25.5 (95% CI: 17.5-37.0), and ESR: 14.6 (95% CI: 11.5-18.6). CONCLUSION: Based on our findings, it appears that among the minor diagnostic criteria, LE has the best performance.
BACKGROUND: Diagnosis of periprosthetic joint infection (PJI) remains a challenge despite a wide variety of available diagnostic tests. The question that arises is which of these tests has a better performance for diagnosing PJI. Diagnostic odds ratio (DOR) has been described as the best indicator for test performance. METHODS: To compare the performance of the standard diagnostic tests, the DOR of serum erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), synovial fluid (SF) white blood cell (WBC) count, SF polymorphonuclear (PMN%), and leukocyte esterase (LE) were calculated. RESULTS: We obtained 4662 ESRs, 4392 CRPs, 836 SF WBC, 804 SF PMN%, and 659 LE results. LE had the highest DOR for diagnosing PJI: 30.06 (95% confidence interval [CI]: 17.8-50.7). The rest of the DORs in the descending order were SF WBC: 29.4 (95% CI: 20.2-42.8), CRP: 25.6 (95% CI: 19.5-33.7), SF PMN%: 25.5 (95% CI: 17.5-37.0), and ESR: 14.6 (95% CI: 11.5-18.6). CONCLUSION: Based on our findings, it appears that among the minor diagnostic criteria, LE has the best performance.
Authors: Louisa Kolbeck; Marco Haertlé; Tilman Graulich; Max Ettinger; Eduardo M Suero; Christian Krettek; Mohamed Omar Journal: In Vivo Date: 2021 May-Jun Impact factor: 2.155
Authors: Nicole Prince; Julia A Penatzer; Taylor L Shackleford; Elizabeth K Stewart; Matthew J Dietz; Jonathan W Boyd Journal: J Orthop Res Date: 2020-12-15 Impact factor: 3.102
Authors: Beata Zatorska; Carla Renata Arciola; Nicolas Haffner; Luigi Segagni Lusignani; Elisabeth Presterl; Magda Diab-Elschahawi Journal: Biomed Res Int Date: 2018-10-22 Impact factor: 3.411
Authors: S M Klim; F Amerstorfer; G Gruber; G A Bernhardt; R Radl; L Leitner; A Leithner; M Glehr Journal: Sci Rep Date: 2018-06-11 Impact factor: 4.379