Significance of Perioperative Tests to Diagnose the Infection in Revision Total Shoulder Arthroplasty

Ahmadi, Shahryar and Lawrence, Thomas M. and Sahota, Shawn and Schleck, Cathy D. and Harmsen, William S. and Cofield, Robert H. and Sperling, John W. (2018) Significance of Perioperative Tests to Diagnose the Infection in Revision Total Shoulder Arthroplasty. The Archives of Bone and Joint Surgery, 6 (5). pp. 359-364.

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Background: The purpose of this study was to evaluate the value of perioperative tests for the diagnosis of infectionin revision shoulder arthroplasty.Methods: A retrospective analysis was performed on 537 shoulder arthroplasties (429 patients) that underwent revisionshoulder 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 revisionarthroplasty. 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 andpositive predictive value.Level of evidence: III

Item Type: Article
Subjects: WE Musculoskeletal system
WO Surgery
Divisions: Journals > Archives of Bone & Joint Surgery
Depositing User: abjs abjs
Date Deposited: 27 Sep 2018 04:57
Last Modified: 27 Sep 2018 04:57

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