Filippo Randelli1, Marco Brioschi2,3, Pietro Randelli4, Federico Ambrogi5, Silvana Sdao6, Alberto Aliprandi6. 1. Hip Department, Orthopedics and Trauma V, IRCCS Policlinico San Donato, S. Donato Milanese, Milan, Italy. 2. Hip Department, Orthopedics and Trauma V, IRCCS Policlinico San Donato, S. Donato Milanese, Milan, Italy. marcobrioschi@outlook.it. 3. Department of Biomedical Sciences for Health, University of Milan, Piazza Malan 2, San. Donato Milanese, 20097, Milan, Italy. marcobrioschi@outlook.it. 4. Department of Biomedical Sciences for Health, University of Milan, Piazza Malan 2, San. Donato Milanese, 20097, Milan, Italy. 5. IRCCS Policlinico San Donato, Piazza Edmondo Malan 1, San. Donato Milanese, 20097, Milan, Italy. 6. Radiology Department, IRCCS Policlinico San Donato, S. Donato Milanese, Milan, Italy.
Abstract
BACKGROUND: Fluid samples obtained from an affected joint still play a central role in the diagnosis of periprosthetic joint infection (PJI). It is the only preoperative test able to discover the causative microbiological agent. In the hip, fluid aspiration can be performed through fluoroscopy, ultrasound, or, less commonly, computed tomography. However, there is still a lack of consensus on which method is preferable in terms of efficacy and costbenefit. PURPOSES: We, therefore, asked whether (1) the benefits in terms of sensitivity and specificity and (2) the costs were comparable between fluoroscopy- and ultrasound-guided joint aspirations in a suspicious of hip PJI. METHODS: Between 2013 and 2016, 52 hip aspirations were performed on 49 patients with clinical, radiological, or serological suspicion of PJI, waiting for a revision surgery. The patients were divided in two groups: fluoroscopy- (n = 26) vs ultrasound-guided hip aspiration group (n = 26). These groups were also divided in control and infected patients. The criteria of MusculoSkeletal Infection Society (MSIS) were used, as gold standard, to define PJI. RESULTS: (1) Ultrasound-guided aspiration revealed valid sensitivity (89% vs 60%) and specificity (94% vs 81%) in comparison with fluoroscopic-guided aspiration. (2) The cost analysis was also in favor of ultrasound-guided aspiration (125.30€) than fluoroscopic-guided aspiration (343.58€). CONCLUSIONS: We concluded that ultrasound-guided hip aspiration could represent a valid, safe, and less expensive diagnostic alternative to fluoroscopic-guided aspiration in hip PJI.
BACKGROUND: Fluid samples obtained from an affected joint still play a central role in the diagnosis of periprosthetic joint infection (PJI). It is the only preoperative test able to discover the causative microbiological agent. In the hip, fluid aspiration can be performed through fluoroscopy, ultrasound, or, less commonly, computed tomography. However, there is still a lack of consensus on which method is preferable in terms of efficacy and costbenefit. PURPOSES: We, therefore, asked whether (1) the benefits in terms of sensitivity and specificity and (2) the costs were comparable between fluoroscopy- and ultrasound-guided joint aspirations in a suspicious of hip PJI. METHODS: Between 2013 and 2016, 52 hip aspirations were performed on 49 patients with clinical, radiological, or serological suspicion of PJI, waiting for a revision surgery. The patients were divided in two groups: fluoroscopy- (n = 26) vs ultrasound-guided hip aspiration group (n = 26). These groups were also divided in control and infectedpatients. The criteria of MusculoSkeletal Infection Society (MSIS) were used, as gold standard, to define PJI. RESULTS: (1) Ultrasound-guided aspiration revealed valid sensitivity (89% vs 60%) and specificity (94% vs 81%) in comparison with fluoroscopic-guided aspiration. (2) The cost analysis was also in favor of ultrasound-guided aspiration (125.30€) than fluoroscopic-guided aspiration (343.58€). CONCLUSIONS: We concluded that ultrasound-guided hip aspiration could represent a valid, safe, and less expensive diagnostic alternative to fluoroscopic-guided aspiration in hip PJI.
Authors: Carmelo Messina; Giuseppe Banfi; Alberto Aliprandi; Giovanni Mauri; Francesco Secchi; Francesco Sardanelli; Luca Maria Sconfienza Journal: Eur Radiol Date: 2015-08-08 Impact factor: 5.315
Authors: Patrick N Weybright; Jon A Jacobson; Kristyn H Murry; John Lin; David P Fessell; David A Jamadar; Mohammed Kabeto; Curtis W Hayes Journal: AJR Am J Roentgenol Date: 2003-07 Impact factor: 3.959
Authors: Heather Roesly; Michael Archibeck; A Michael Henrie; Justin Provo; Justin Foley; Andrew Boyer; Masaru Teramoto; Daniel M Cushman Journal: J Orthop Date: 2022-09-14
Authors: Sebastian Philipp Boelch; Manuel Weissenberger; Frederik Spohn; Maximilian Rudert; Martin Luedemann Journal: J Orthop Surg Res Date: 2018-01-10 Impact factor: 2.359
Authors: Justin Ong; Alex Tang; Joshua C Rozell; James S Babb; Ran Schwarzkopf; Dana Lin Journal: J Orthop Surg Res Date: 2022-01-22 Impact factor: 2.359