BACKGROUND: The purpose of this study was to evaluate the value of perioperative tests for the diagnosis of infection in revision shoulder arthroplasty. METHODS: A retrospective analysis was performed on 537 shoulder arthroplasties (429 patients) that underwent revision shoulder arthroplasty at our institution. Periprosthetic tissue cultures were positive in 169/537 surgeries. RESULTS: White-blood cell count (WBC) was elevated in 3.8% revision arthroplasties. Erythrocyte sedimentation rate (ESR) was elevated in 23.1% revision arthroplasties. The C-reactive protein (CRP) was elevated in 20.8% revision arthroplasties. Bone scans (technetium, indium) were performed on 9.9% patients and it was positive for osteomyelitis in just one revision arthroplasty. Intra-operative pathology was read as consistent with acute inflammation in 11.9% revision arthroplasties. The positive and negative predictive values for intra-operative pathology were 56.7% and 71.6% respectively. CONCLUSION: All of the perioperative tests had a high specificity and negative predictive value, but low sensitivity and positive predictive value.
BACKGROUND: The purpose of this study was to evaluate the value of perioperative tests for the diagnosis of infection in revision shoulder arthroplasty. METHODS: A retrospective analysis was performed on 537 shoulder arthroplasties (429 patients) that underwent revision shoulder arthroplasty at our institution. Periprosthetic tissue cultures were positive in 169/537 surgeries. RESULTS: White-blood cell count (WBC) was elevated in 3.8% revision arthroplasties. Erythrocyte sedimentation rate (ESR) was elevated in 23.1% revision arthroplasties. The C-reactive protein (CRP) was elevated in 20.8% revision arthroplasties. Bone scans (technetium, indium) were performed on 9.9% patients and it was positive for osteomyelitis in just one revision arthroplasty. Intra-operative pathology was read as consistent with acute inflammation in 11.9% revision arthroplasties. The positive and negative predictive values for intra-operative pathology were 56.7% and 71.6% respectively. CONCLUSION: All of the perioperative tests had a high specificity and negative predictive value, but low sensitivity and positive predictive value.
Authors: Mauricio F Herrera; Greg Bauer; Fletcher Reynolds; Richard M Wilk; Louis U Bigliani; William N Levine Journal: J Shoulder Elbow Surg Date: 2002 Nov-Dec Impact factor: 3.019
Authors: Adam Seidl; Daniel Sholder; William Warrender; Michael Livesey; Gerald Williams; Joseph Abboud; Surena Namdari Journal: Arch Bone Jt Surg Date: 2017-07
Authors: B L Atkins; N Athanasou; J J Deeks; D W Crook; H Simpson; T E Peto; P McLardy-Smith; A R Berendt Journal: J Clin Microbiol Date: 1998-10 Impact factor: 5.948
Authors: Amy K Franta; Tim R Lenters; Doug Mounce; Blazej Neradilek; Frederick A Matsen Journal: J Shoulder Elbow Surg Date: 2007-05-16 Impact factor: 3.019