Possibilities of latent PJI detection in revision knee arthroplasty

periprosthetic joint infection in patients admitted for revision knee arthroplasty due to aseptic loosening and after spacer implantation. Materials and methods Group 1 included 49 patients who underwent revision knee arthroplasty due to aseptic loosening, group 2 were 47 patients with PJI after s...

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Autores principales: Alexander N. Panteleev, Svetlana A. Bozhkova, Petr M. Preobrazhensky, Alexander V. Kazemirsky
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Publicado: Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics 2021
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Acceso en línea:https://doaj.org/article/23f7320b156c48f5afa12ebe9e3b992e
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spelling oai:doaj.org-article:23f7320b156c48f5afa12ebe9e3b992e2021-11-15T10:01:44ZPossibilities of latent PJI detection in revision knee arthroplasty10.18019/1028-4427-2021-27-5-562-5691028-44272542-131Xhttps://doaj.org/article/23f7320b156c48f5afa12ebe9e3b992e2021-10-01T00:00:00Zhttps://doaj.org/toc/1028-4427https://doaj.org/toc/2542-131Xperiprosthetic joint infection in patients admitted for revision knee arthroplasty due to aseptic loosening and after spacer implantation. Materials and methods Group 1 included 49 patients who underwent revision knee arthroplasty due to aseptic loosening, group 2 were 47 patients with PJI after spacer implantation. Results and discussion There were no significant differences between patient groups in terms of age, gender, and preoperative ESR and CRP levels. In 62.2 % of all cases, the aspirate was inappropriate for cytological examination; this fact limited its diagnostic value. The most frequently intraoperatively isolated pathogen in both groups was coagulase-negative staphylococci. However, in 70 % of cases these results were not diagnostically significant, and infection was diagnosed only in 8.2 % of cases in group 1 and 12.8 % in group 2. Moreover, the chances of isolating the pathogen from tissue biopsies were 5.6 times higher than from intraoperative aspirate (OR = 5.6, 95 % CI = 1.2-26.4). In case of negative preoperative aspirate, in almost 25 % of cases, pathogens were isolated from intraoperative tissues, 40.9 % of them were diagnostically significant. The chances of its detection increased 4.7 times in combined increase in ESR and CRP blood level (OR = 4.686, 95 % CI = 0.765-28.700). Using EBJIS 2021 criteria, infection was confirmed in more than 10 % of cases in each group, and the diagnostic significance of the criteria exceeded the significance of using routine screening methods. At a follow-up period of more than 2 years, the effectiveness of treatment was 95.3 %, while signs of infection were detected in 4.7 % of cases, regardless of the group. Conclusion EBJIS 2021 criteria are characterized by high diagnostic sensitivity and specificity and enable to identify periprosthetic joint infection in knee revision cases even in its latent form and to correct treatment tactics in patients without a history of PJI.Alexander N. PanteleevSvetlana A. BozhkovaPetr M. PreobrazhenskyAlexander V. KazemirskyRussian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedicsarticlerevision arthroplastyknee jointperiprosthetic joint infectionOrthopedic surgeryRD701-811ENRUГений oртопедии, Vol 27, Iss 5, Pp 562-569 (2021)
institution DOAJ
collection DOAJ
language EN
RU
topic revision arthroplasty
knee joint
periprosthetic joint infection
Orthopedic surgery
RD701-811
spellingShingle revision arthroplasty
knee joint
periprosthetic joint infection
Orthopedic surgery
RD701-811
Alexander N. Panteleev
Svetlana A. Bozhkova
Petr M. Preobrazhensky
Alexander V. Kazemirsky
Possibilities of latent PJI detection in revision knee arthroplasty
description periprosthetic joint infection in patients admitted for revision knee arthroplasty due to aseptic loosening and after spacer implantation. Materials and methods Group 1 included 49 patients who underwent revision knee arthroplasty due to aseptic loosening, group 2 were 47 patients with PJI after spacer implantation. Results and discussion There were no significant differences between patient groups in terms of age, gender, and preoperative ESR and CRP levels. In 62.2 % of all cases, the aspirate was inappropriate for cytological examination; this fact limited its diagnostic value. The most frequently intraoperatively isolated pathogen in both groups was coagulase-negative staphylococci. However, in 70 % of cases these results were not diagnostically significant, and infection was diagnosed only in 8.2 % of cases in group 1 and 12.8 % in group 2. Moreover, the chances of isolating the pathogen from tissue biopsies were 5.6 times higher than from intraoperative aspirate (OR = 5.6, 95 % CI = 1.2-26.4). In case of negative preoperative aspirate, in almost 25 % of cases, pathogens were isolated from intraoperative tissues, 40.9 % of them were diagnostically significant. The chances of its detection increased 4.7 times in combined increase in ESR and CRP blood level (OR = 4.686, 95 % CI = 0.765-28.700). Using EBJIS 2021 criteria, infection was confirmed in more than 10 % of cases in each group, and the diagnostic significance of the criteria exceeded the significance of using routine screening methods. At a follow-up period of more than 2 years, the effectiveness of treatment was 95.3 %, while signs of infection were detected in 4.7 % of cases, regardless of the group. Conclusion EBJIS 2021 criteria are characterized by high diagnostic sensitivity and specificity and enable to identify periprosthetic joint infection in knee revision cases even in its latent form and to correct treatment tactics in patients without a history of PJI.
format article
author Alexander N. Panteleev
Svetlana A. Bozhkova
Petr M. Preobrazhensky
Alexander V. Kazemirsky
author_facet Alexander N. Panteleev
Svetlana A. Bozhkova
Petr M. Preobrazhensky
Alexander V. Kazemirsky
author_sort Alexander N. Panteleev
title Possibilities of latent PJI detection in revision knee arthroplasty
title_short Possibilities of latent PJI detection in revision knee arthroplasty
title_full Possibilities of latent PJI detection in revision knee arthroplasty
title_fullStr Possibilities of latent PJI detection in revision knee arthroplasty
title_full_unstemmed Possibilities of latent PJI detection in revision knee arthroplasty
title_sort possibilities of latent pji detection in revision knee arthroplasty
publisher Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics
publishDate 2021
url https://doaj.org/article/23f7320b156c48f5afa12ebe9e3b992e
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AT alexandervkazemirsky possibilitiesoflatentpjidetectioninrevisionkneearthroplasty
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