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Defining a synovial fluid white blood cell count threshold to predict periprosthetic infection after shoulder arthroplasty
Please always quote using this URN: urn:nbn:de:bvb:20-opus-252275
- Background: The diagnosis of periprosthetic shoulder infection (PSI) requires a thorough diagnostic workup. Synovial fluid aspiration has been proven to be a reliable tool in the diagnosis of joint infections of the lower extremity, but shoulder specific data is limited. This study defines a threshold for synovial fluid white blood cell count (WBC) and assesses the reliability of microbiological cultures. Methods: Retrospective study of preoperative and intraoperative fluid aspiration of 31 patients who underwent a revision of a shoulderBackground: The diagnosis of periprosthetic shoulder infection (PSI) requires a thorough diagnostic workup. Synovial fluid aspiration has been proven to be a reliable tool in the diagnosis of joint infections of the lower extremity, but shoulder specific data is limited. This study defines a threshold for synovial fluid white blood cell count (WBC) and assesses the reliability of microbiological cultures. Methods: Retrospective study of preoperative and intraoperative fluid aspiration of 31 patients who underwent a revision of a shoulder arthroplasty (15 with PSI defined by IDSA criteria, 16 without infection). The threshold for WBC was calculated by ROC/AUC analysis. Results: WBC was significantly higher in patients with PSI than in other patients. A threshold of 2800 leucocytes/mm\(^3\) showed a sensitivity of 87% and a specificity of 88% (AUROC 0.92). Microbiological cultures showed a sensitivity of 76% and a specificity of 100%. Conclusions: A threshold of 2800 leucocytes/mm\(^3\) in synovial fluid can be recommended to predict PSI. Microbiological culture has an excellent specificity and allows for targeted antibiotic therapy. Joint aspiration presents an important pillar to diagnose PSI.…
Author: | Laura Elisa Streck, Chiara Gaal, Johannes Forster, Christian Konrads, Sebastian Philipp von Hertzberg-Boelch, Kilian Rueckl |
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URN: | urn:nbn:de:bvb:20-opus-252275 |
Document Type: | Journal article |
Faculties: | Medizinische Fakultät / Institut für Hygiene und Mikrobiologie |
Medizinische Fakultät / Lehrstuhl für Orthopädie | |
Language: | English |
Parent Title (English): | Journal of Clinical Medicine |
ISSN: | 2077-0383 |
Year of Completion: | 2021 |
Volume: | 11 |
Issue: | 1 |
Article Number: | 50 |
Source: | Journal of Clinical Medicine (2022) 11:1, 50. https://doi.org/10.3390/jcm11010050 |
DOI: | https://doi.org/10.3390/jcm11010050 |
Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
Tag: | ICM; IDSA; MSIS; WBC; cutibacteria; joint aspiration; joint infection; leucocyte count; upper extremity |
Release Date: | 2022/09/12 |
Date of first Publication: | 2021/12/23 |
Licence (German): | CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International |