Is Procalcitonin (PCT) a reliable biomarker for preoperative diagnosing of low grade periprosthetic joint infection? A prospective study

Busch, André; Jäger, Markus; Engler, Harald; Haversath, Marcel; Bielefeld, Charlotte; Landgraeber, Stefan

doi:10.1186/s12891-020-03266-6

Cited by 15 publications

(20 citation statements)

References 45 publications

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“…The group included 22 women and 11 men with a mean age of 70.4 ± 13.7 (42-88) years. The mean BMI was 28.6 ± 5.4 (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40). In the same period, 12 patients were classi ed as having a PJI.…”

Section: Patientsmentioning

confidence: 99%

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Metal Artefact Reduction Sequences (MARS) in Magnetic Resonance Imaging (MRI) After Total Hip Arthroplasty (THA). A Non-Invasive Approach for Preoperative Differentiation Between Periprosthetic Joint Infection (PJI) and Aseptic Complications?

Busch

Jäger

Beck

et al. 2022

Preprint

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Background:In the past, radiographic imaging was of minor relevance in the diagnosis of periprosthetic joint infections (PJI). Since metal artefact reduction sequences (MARS) are available, magnetic resonance imaging (MRI) has become a promising diagnostic tool for the evaluation of hip arthroplasty implants. The purpose of the present study was to evaluate the efficacy of MARS MRI in comparison to established diagnostic tools to distinguish between aseptic failure and PJI.Methods:Between July 2018 to September 2019, MARS-MRI was conducted using the optimized parameters at 1.5 T in a coronal and axial STIR (short-tau-inversion recovery), a non-fat-saturated T2 in coronal view and a non-fat-saturated T1 in transverse view in 45 patients with painful hip after THA.Results:Synovial layering and muscle edema were significant features of periprosthetic joint infection, with sensitivities of 100% and specifities of 63.0 - 75.0%. The combined specifity and sensitivity levels of synovial layering and muscular edema was 88.0% and 90.0%. Granulomatous synovitis was a significant feature for aseptic failure, with 90.0% sensitivity and 57.0% specifity.Conclusion:MARS-MRI is as suitable as standard diagnostic tools to distinguish between aseptic failure and PJI in patients with a total hip arthroplasty (TJA). Further studies with larger patient numbers have to prove whether MARS-MRI could be integral part of PJI diagnostic.

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Section: Patientsmentioning

confidence: 99%

“…The mean BMI was 29.2 ± 5.0 (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37). Bacteria were identi ed in 10 (83%) of 12 patients of the infection group.…”

Section: Patientsmentioning

confidence: 99%

Metal Artefact Reduction Sequences (MARS) in Magnetic Resonance Imaging (MRI) After Total Hip Arthroplasty (THA). A Non-Invasive Approach for Preoperative Differentiation Between Periprosthetic Joint Infection (PJI) and Aseptic Complications?

Busch

Jäger

Beck

et al. 2022

Preprint

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“…The diagnosis of PJI is still a major problem in orthopaedic surgery because so far no “gold-standard” has been established [ 22 ]. Radiographic imaging is a keystone in orthopaedic diagnostics because it is non-invasive and available almost everywhere.…”

Section: Discussionmentioning

confidence: 99%

“…The group consisted of 9 women and 3 men with a mean age of 72.5 ± 10.6 (54-88) years. The mean BMI was 29.2 ± 5.0 (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37). Bacteria were identified in 10 (83%) of 12 patients of the infection group.…”

Section: Patientsmentioning

confidence: 99%

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Metal Artefact Reduction Sequences (MARS) in Magnetic Resonance Imaging (MRI) after Total Hip Arthroplasty (THA)

Busch

Jäger

Beck

et al. 2022

BMC Musculoskelet Disord

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Background In the past, radiographic imaging was of minor relevance in the diagnosis of periprosthetic joint infections (PJI). Since metal artefact reduction sequences (MARS) are available, magnetic resonance imaging (MRI) has become a promising diagnostic tool for the evaluation of hip arthroplasty implants. The purpose of the present study was to evaluate the efficacy of MARS-MRI in comparison to established diagnostic tools to distinguish between aseptic failure and PJI. Methods From July 2018 to September 2019, 33 patients classified as having an aseptic joint effusion were recruited into the study. The group included 22 women and 11 men with a mean age of 70.4 ± 13.7 (42–88) years. In the same period, 12 patients were classified as having a PJI. The group consisted of 9 women and 3 men with a mean age of 72.5 ± 10.6 (54–88) years. MARS-MRI was conducted using the optimized parameters at 1.5 T in a coronal and axial STIR (short-tau-inversion recovery), a non-fat-saturated T2 in coronal view and a non-fat-saturated T1 in transverse view in 45 patients with painful hip after total hip arthroplasty (THA). Normally distributed continuous data were shown as mean ± standard deviation (SD) and compared using student's t-test. Non-normally distributed continuous data were shown as mean and compared using the Mann–Whitney U test. Results Synovial layering and muscle edema were significant features of periprosthetic joint infection, with sensitivities of 100% and specifities of 63.0—75.0%. The combined specifity and sensitivity levels of synovial layering and muscular edema was 88.0% and 90.0%. Granulomatous synovitis was a significant feature for aseptic failure, with 90.0% sensitivity and 57.0% specifity. Conclusion MARS-MRI is as suitable as standard diagnostic tools to distinguish between aseptic failure and PJI in patients with THA. Further studies with larger patient numbers have to prove whether MARS-MRI could be integral part of PJI diagnostic.

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Preoperative Planning for Revision Arthroplasty: Imaging, Instruments, and Implants

Porcellini,

Delvecchio,

Giorgini

et al. 2023

Revision Shoulder Arthroplasty

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Is Procalcitonin (PCT) a reliable biomarker for preoperative diagnosing of low grade periprosthetic joint infection? A prospective study

Cited by 15 publications

References 45 publications

Metal Artefact Reduction Sequences (MARS) in Magnetic Resonance Imaging (MRI) After Total Hip Arthroplasty (THA). A Non-Invasive Approach for Preoperative Differentiation Between Periprosthetic Joint Infection (PJI) and Aseptic Complications?

Metal Artefact Reduction Sequences (MARS) in Magnetic Resonance Imaging (MRI) After Total Hip Arthroplasty (THA). A Non-Invasive Approach for Preoperative Differentiation Between Periprosthetic Joint Infection (PJI) and Aseptic Complications?

Metal Artefact Reduction Sequences (MARS) in Magnetic Resonance Imaging (MRI) after Total Hip Arthroplasty (THA)

Preoperative Planning for Revision Arthroplasty: Imaging, Instruments, and Implants

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