Risk Factors for Periprosthetic Joint Infection Following Primary Total Hip Arthroplasty: A Case Control Study

Bozic, Kevin J.; Ward, Derek; Lau, Edmund; Chan, Vanessa; Wetters, Nathan G.; Naziri, Qais; Odum, Susan M.; Fehring, Thomas K.; Mont, Michael A.; Gioe, Terence J.; Valle, Craig J. Della

doi:10.1016/j.arth.2013.04.015

Cited by 71 publications

(45 citation statements)

References 19 publications

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“…Of the numerous preoperative tests available-including white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), and Creactive protein (CRP) levels-no test has perfect sensitivity and specificity (1,7,10,44). However, their diagnostic ability is not entirely reliable; a recent meta-analysis showed that the sensitivity and specificity of WBC count, ESR, and CRP levels were 45%, 75%, and 88% and 87%, 70%, and 74%, respectively (44).…”

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confidence: 99%

“…The diagnosis of PJI after TJA remains a challenge (1,7,10). Of the numerous preoperative tests available-including white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), and Creactive protein (CRP) levels-no test has perfect sensitivity and specificity (1,7,10,44).…”

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confidence: 99%

“…rosthetic joint infection (PJI) is a common and challenging complication for both patients and surgeons (1)(2)(3)(4). The incidence of PJI after total joint arthroplasty (TJA) is 1 to 12% (5,6).…”

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confidence: 99%

“…A multitude of preoperative tests are available to clinicians for diagnosing PJI, including preoperative laboratory testing and radiological examination (7). However, the limited sensitivity and specificity of these tests pose difficulties in distinguishing between PJI and other causes of joint failure, such as aseptic loosening (1,8). Guidelines by the American Academy of Orthopaedic Surgeons (AAOS) and Infectious Diseases Society of America (IDSA) strongly recommend preoperative aspiration culture for assessment for PJI (9,10).…”

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confidence: 99%

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Preoperative Aspiration Culture for Preoperative Diagnosis of Infection in Total Hip or Knee Arthroplasty

Zhai

et al. 2013

J Clin Microbiol

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dThis meta-analysis evaluated preoperative aspiration culture for diagnosing prosthetic joint infection (PJI) in total hip arthroplasty (THA) and total knee arthroplasty (TKA). The pooled sensitivity and specificity were 0.72 (95% confidence interval, 0.65 to 0.78) and 0.95 (0.93 to 0.97), respectively. Subgroup analyses revealed nonsignificant worse diagnostic performance for THA than for TKA (sensitivity, 0.70 versus 0.78; specificity, 0.94 versus 0.96). Preoperative aspiration culture has moderate to high sensitivity and very high specificity for diagnosing PJI.

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confidence: 99%

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Preoperative Aspiration Culture for Preoperative Diagnosis of Infection in Total Hip or Knee Arthroplasty

Zhai

et al. 2013

J Clin Microbiol

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“…Recent studies on infection after ACL reconstruction have demonstrated that graft choice may be a risk factor 1,4 . Smoking has been shown to be a risk factor for infection after orthopaedic surgery 5,6 , and obesity increases the risk of infection after spinal surgery 7,8 and arthroplasty 9,10 . Diabetes is well known to be associated with an elevated risk of surgical site infections in a variety of surgical specialties [11][12][13] , including orthopaedics 8,[14][15][16][17][18][19] .…”

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confidence: 99%