Peter L C Lapner1, Kelly Hynes2, Adnan Sheikh3. 1. Division of Orthopedics, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada. 2. The University of Chicago Medicine, Department of Orthopaedic Surgery and Rehabilitation Medicine, Chicago, IL, USA. 3. Department of Radiology, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.
Abstract
BACKGROUND: Establishing the diagnosis of peri-prosthetic shoulder infection prior to revision shoulder arthroplasty can be difficult. The objectives of the present study were (i) to describe the technique of fluoroscopic capsular needle biopsy for the diagnosis of peri-prosthetic shoulder infection and (ii) to determine the feasibility and preliminary accuracy of the test in a pilot sample of patients undergoing revision shoulder arthroplasty. METHODS: Eighteen patients, comprising eight females and nine males with a mean age of 61 years (range 37 years to 81 years) underwent capsular needle biopsy during the work-up of suspected chronic arthroplasty-related glenohumeral infection. Intra-operative tissue samples were taken from a minimum of three regions of the joint capsule during revision surgery. Standard serum indices were obtained. RESULTS: Of 17 patients with possible infection, five had confirmed culture positive infections based on intra-operative biopsies. Of these five patients, four (80%) had positive cultures from fluoroscopic capsular needle biopsy, with matching cultures. There were no complications. No culture-positive patients had elevated serum indices for infection. CONCLUSIONS: The technique for fluoroscopic capsular needle biopsy appears to be feasible and the preliminary results for this technique appear to be promising, with a sensitivity of 80% and a specificity of 100%.Level of evidence: Level II: diagnostic test.
BACKGROUND: Establishing the diagnosis of peri-prosthetic shoulder infection prior to revision shoulder arthroplasty can be difficult. The objectives of the present study were (i) to describe the technique of fluoroscopic capsular needle biopsy for the diagnosis of peri-prosthetic shoulder infection and (ii) to determine the feasibility and preliminary accuracy of the test in a pilot sample of patients undergoing revision shoulder arthroplasty. METHODS: Eighteen patients, comprising eight females and nine males with a mean age of 61 years (range 37 years to 81 years) underwent capsular needle biopsy during the work-up of suspected chronic arthroplasty-related glenohumeral infection. Intra-operative tissue samples were taken from a minimum of three regions of the joint capsule during revision surgery. Standard serum indices were obtained. RESULTS: Of 17 patients with possible infection, five had confirmed culture positive infections based on intra-operative biopsies. Of these five patients, four (80%) had positive cultures from fluoroscopic capsular needle biopsy, with matching cultures. There were no complications. No culture-positive patients had elevated serum indices for infection. CONCLUSIONS: The technique for fluoroscopic capsular needle biopsy appears to be feasible and the preliminary results for this technique appear to be promising, with a sensitivity of 80% and a specificity of 100%.Level of evidence: Level II: diagnostic test.
Authors: Jirí Gallo; Milan Raska; Milos Dendis; Anthony V Florschütz; Milan Kolár Journal: Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub Date: 2004-12 Impact factor: 1.245
Authors: Christopher C Dodson; Edward V Craig; Frank A Cordasco; David M Dines; Joshua S Dines; Edward Dicarlo; Barry D Brause; Russell F Warren Journal: J Shoulder Elbow Surg Date: 2009-11-01 Impact factor: 3.019
Authors: Lluís Font-Vizcarra; Sebastián García; Juan C Martínez-Pastor; Josep M Sierra; Alex Soriano Journal: Clin Orthop Relat Res Date: 2010-02-17 Impact factor: 4.176
Authors: Kerryl E Piper; Marta Fernandez-Sampedro; Kathryn E Steckelberg; Jayawant N Mandrekar; Melissa J Karau; James M Steckelberg; Elie F Berbari; Douglas R Osmon; Arlen D Hanssen; David G Lewallen; Robert H Cofield; John W Sperling; Joaquin Sanchez-Sotelo; Paul M Huddleston; Mark B Dekutoski; Michael Yaszemski; Bradford Currier; Robin Patel Journal: PLoS One Date: 2010-02-22 Impact factor: 3.240