Tests for predicting reimplantation success of two-stage revision for periprosthetic joint infection: A systematic review and meta-analysis

Orthopaedics & Traumatology, Surgery & Research : OTSR
Tao BianYang Song

Abstract

Several tests are used before reimplantation to detect persistent infection in patients with periprosthetic joint infection (PJI) undergoing two-stage revision. However, there is no consensus as to the optimal tests for excluding persistent infection or predicting successful reimplantation by stage. We aimed to determine the accuracy of different tests used to detect persistent infection after the first stage, and/or predicting failure following reimplantation in patients with PJI. We conducted a systematic review and meta-analysis of PubMed, Embase and the Cochrane Library databases. Two reviewers independently conducted quality assessments and data extractions to estimate pooled sensitivity and specificity, diagnostic odds ratio and area under the receiver operating characteristic curves (AUSROC) for each test. We included 24 studies published between May 1999 and September 2017. Synovial fluid polymorphonuclear neutrophils (PMN)% had the highest sensitivity of 0.70, followed by serum erythrocyte sedimentation rate (0.57) and spacer sonication fluid culture (0.53). Synovial fluid culture had the highest specificity of 0.97, followed by frozen section (0.93) and the Musculoskeletal Infection Society criteria (0.92). Spacer son...Continue Reading

Citations

Jul 12, 2020·Journal of Orthopaedic Surgery and Research·Cheng LiAndrej Trampuz
Dec 10, 2019·Orthopaedics & Traumatology, Surgery & Research : OTSR·Jean-Yves Jenny
Feb 27, 2021·Journal of Biomedical Materials Research. Part B, Applied Biomaterials·Augustina JeyanathanMelanie J Coathup
Mar 29, 2021·Orthopaedics & Traumatology, Surgery & Research : OTSR·Erdem SahinGokhan Kaynak

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