Value of ultrasound-guided aspiration of hip arthroplasties performed in an orthopedic clinic by orthopedic surgeons

<p><strong>Background</strong>: Total joint arthroplasties continue to increase as do periprosthetic joint infections (PJIs). Ultrasound-guided aspiration can yield useful synovial fluid for analysis while avoiding radiation exposure. This study presents a high-yield, ultrasound-gu...

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Autores principales:	H. Duck, S. Tanner, D. Zillmer, D. Osmon, K. Perry
Formato:	article
Lenguaje:	EN
Publicado:	Copernicus Publications 2021
Materias:	Orthopedic surgery RD701-811
Acceso en línea:	https://doaj.org/article/caa6cd4fe9ed41cab01f455967767ca7
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spelling	oai:doaj.org-article:caa6cd4fe9ed41cab01f455967767ca72021-11-10T06:55:10ZValue of ultrasound-guided aspiration of hip arthroplasties performed in an orthopedic clinic by orthopedic surgeons10.5194/jbji-6-393-20212206-3552https://doaj.org/article/caa6cd4fe9ed41cab01f455967767ca72021-11-01T00:00:00Zhttps://jbji.copernicus.org/articles/6/393/2021/jbji-6-393-2021.pdfhttps://doaj.org/toc/2206-3552<p><strong>Background</strong>: Total joint arthroplasties continue to increase as do periprosthetic joint infections (PJIs). Ultrasound-guided aspiration can yield useful synovial fluid for analysis while avoiding radiation exposure. This study presents a high-yield, ultrasound-guided technique with analysis of aspiration results. <strong>Methods</strong>: All consecutive ultrasound-guided aspirations of hip arthroplasties performed from May 2016 through to April 2019 were retrospectively reviewed. Patient demographic information, component specifics, presence of draining sinus, and inflammatory markers were recorded. Results of aspiration including volume, appearance, lavage use, synovial fluid differential leukocyte count, synovial neutrophil percent, and culture results were recorded. Surgical results, specimen cultures, and surgeon description of purulence were recorded. Aspiration results were compared to the surgical specimen results in all patients who underwent reoperations. <strong>Results</strong>: Review of 349 hip aspirations demonstrated accuracy of 87 %, sensitivity of 83 %, specificity of 89 %, positive predictive value of 79 %, and negative predictive value 91 %. Surgical and aspiration cultures matched in 81 % of cases. Bloody aspirates and aspirates obtained after lavage had less accuracy at 69 % and 60 %, respectively. Specificity was 100 % for cultures obtained with lavage and 91 % for bloody aspirates. Synovial leukocyte count and neutrophil percentage was obtained in 85 % of aspirations, and cultures were obtained in 98 % of aspirates. Contamination rate was 2 %. <strong>Conclusion</strong>: Ultrasound-guided aspirations aid in the diagnosis of PJI. The use of lavage to obtain fluid is helpful when aspiration cultures are positive. Bloody aspirates are less accurate but have high specificity. A low contamination rate and 88 % accuracy results with this meticulous technique.</p>H. DuckS. TannerD. ZillmerD. OsmonK. PerryCopernicus PublicationsarticleOrthopedic surgeryRD701-811ENJournal of Bone and Joint Infection, Vol 6, Pp 393-403 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Orthopedic surgery RD701-811
spellingShingle	Orthopedic surgery RD701-811 H. Duck S. Tanner D. Zillmer D. Osmon K. Perry Value of ultrasound-guided aspiration of hip arthroplasties performed in an orthopedic clinic by orthopedic surgeons
description	<p><strong>Background</strong>: Total joint arthroplasties continue to increase as do periprosthetic joint infections (PJIs). Ultrasound-guided aspiration can yield useful synovial fluid for analysis while avoiding radiation exposure. This study presents a high-yield, ultrasound-guided technique with analysis of aspiration results. <strong>Methods</strong>: All consecutive ultrasound-guided aspirations of hip arthroplasties performed from May 2016 through to April 2019 were retrospectively reviewed. Patient demographic information, component specifics, presence of draining sinus, and inflammatory markers were recorded. Results of aspiration including volume, appearance, lavage use, synovial fluid differential leukocyte count, synovial neutrophil percent, and culture results were recorded. Surgical results, specimen cultures, and surgeon description of purulence were recorded. Aspiration results were compared to the surgical specimen results in all patients who underwent reoperations. <strong>Results</strong>: Review of 349 hip aspirations demonstrated accuracy of 87 %, sensitivity of 83 %, specificity of 89 %, positive predictive value of 79 %, and negative predictive value 91 %. Surgical and aspiration cultures matched in 81 % of cases. Bloody aspirates and aspirates obtained after lavage had less accuracy at 69 % and 60 %, respectively. Specificity was 100 % for cultures obtained with lavage and 91 % for bloody aspirates. Synovial leukocyte count and neutrophil percentage was obtained in 85 % of aspirations, and cultures were obtained in 98 % of aspirates. Contamination rate was 2 %. <strong>Conclusion</strong>: Ultrasound-guided aspirations aid in the diagnosis of PJI. The use of lavage to obtain fluid is helpful when aspiration cultures are positive. Bloody aspirates are less accurate but have high specificity. A low contamination rate and 88 % accuracy results with this meticulous technique.</p>
format	article
author	H. Duck S. Tanner D. Zillmer D. Osmon K. Perry
author_facet	H. Duck S. Tanner D. Zillmer D. Osmon K. Perry
author_sort	H. Duck
title	Value of ultrasound-guided aspiration of hip arthroplasties performed in an orthopedic clinic by orthopedic surgeons
title_short	Value of ultrasound-guided aspiration of hip arthroplasties performed in an orthopedic clinic by orthopedic surgeons
title_full	Value of ultrasound-guided aspiration of hip arthroplasties performed in an orthopedic clinic by orthopedic surgeons
title_fullStr	Value of ultrasound-guided aspiration of hip arthroplasties performed in an orthopedic clinic by orthopedic surgeons
title_full_unstemmed	Value of ultrasound-guided aspiration of hip arthroplasties performed in an orthopedic clinic by orthopedic surgeons
title_sort	value of ultrasound-guided aspiration of hip arthroplasties performed in an orthopedic clinic by orthopedic surgeons
publisher	Copernicus Publications
publishDate	2021
url	https://doaj.org/article/caa6cd4fe9ed41cab01f455967767ca7
work_keys_str_mv	AT hduck valueofultrasoundguidedaspirationofhiparthroplastiesperformedinanorthopedicclinicbyorthopedicsurgeons AT stanner valueofultrasoundguidedaspirationofhiparthroplastiesperformedinanorthopedicclinicbyorthopedicsurgeons AT dzillmer valueofultrasoundguidedaspirationofhiparthroplastiesperformedinanorthopedicclinicbyorthopedicsurgeons AT dosmon valueofultrasoundguidedaspirationofhiparthroplastiesperformedinanorthopedicclinicbyorthopedicsurgeons AT kperry valueofultrasoundguidedaspirationofhiparthroplastiesperformedinanorthopedicclinicbyorthopedicsurgeons
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Value of ultrasound-guided aspiration of hip arthroplasties performed in an orthopedic clinic by orthopedic surgeons

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