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Verfasst von:Fink, Bernd [VerfasserIn]   i
 Gebhard, Alexander [VerfasserIn]   i
 Fuerst, Martin [VerfasserIn]   i
 Berger, Irina [VerfasserIn]   i
 Schäfer, Peter [VerfasserIn]   i
Titel:High diagnostic value of synovial biopsy in periprosthetic joint infection of the hip
Verf.angabe:Bernd Fink, MD; Alexander Gebhard, MD; Martin Fuerst, MD; Irina Berger, MD; Peter Schäfer, MD
Jahr:2013
Jahr des Originals:2012
Umfang:9 S.
Teil:volume:471
 year:2013
 number:3
 pages:956-964
 extent:9
Fussnoten:Published online 18 July 2012 ; Gesehen am 06.04.2021
Titel Quelle:Enthalten in: Clinical orthopaedics and related research
Ort Quelle:Philadelphia, PA : Wolters Kluwer Health, 1963
Jahr Quelle:2013
Band/Heft Quelle:471(2013), 3, Seite 956-964
ISSN Quelle:1528-1132
Abstract:BACKGROUND: The role of the synovial biopsy in the preoperative diagnosis of a periprosthetic joint infection (PJI) of the hip has not been clearly defined. - QUESTIONS/PURPOSES: We asked whether the value of a biopsy for a PJI is greater than that of aspiration and C-reactive protein (CRP). - METHODS: Before revision in 100 hip endoprostheses, we obtained CRP values, aspirated the joint, and obtained five synovial biopsy samples for bacteriologic analysis and five for histologic analysis. Microbiologic and histologic analyses of the periprosthetic tissue during revision surgery were used to verify the results of the preoperative diagnostic methods. The minimum followup was 24 months (median 32; range, 24-47 months). - RESULTS: Forty-five of the 100 prostheses were identified as infected. The biopsy, with a combination of the bacteriologic and histologic examinations, showed the greatest diagnostic value of all the diagnostic procedures and led to a sensitivity of 82% (95% CI, ± 11%), specificity of 98% (95% CI, ± 4%), positive predictive value of 97% (95% CI, ± 5%), negative predictive value of 87% (95% CI, ± 8.3%), and accuracy of 91%. - CONCLUSIONS: The biopsy technique has a greater value than aspiration and CRP in the diagnosis of PJI of the hip (Masri et al. J Arthroplasty 22:72-78, 2007). In patients with a negative aspirate, but increased CRP or clinical signs of infection, we regard biopsy to be preferable to just repeating the aspiration. - LEVEL OF EVIDENCE: Level II prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
DOI:doi:10.1007/s11999-012-2474-5
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

Volltext: https://doi.org/10.1007/s11999-012-2474-5
 DOI: https://doi.org/10.1007/s11999-012-2474-5
Datenträger:Online-Ressource
Sprache:eng
Sach-SW:Adult
 Aged
 Aged, 80 and over
 Arthroplasty, Replacement, Hip
 Bacteriological Techniques
 Biomarkers
 Biopsy
 Biopsy, Needle
 C-Reactive Protein
 Female
 Hip Joint
 Hip Prosthesis
 Humans
 Male
 Middle Aged
 Predictive Value of Tests
 Prospective Studies
 Prosthesis-Related Infections
 Reoperation
 Sensitivity and Specificity
 Synovectomy
 Synovial Membrane
K10plus-PPN:1753173205
Verknüpfungen:→ Zeitschrift

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