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首页> 外文期刊>Journal of Clinical Medicine >Increased Diagnostic Certainty of Periprosthetic Joint Infections by Combining Microbiological Results with Histopathological Samples Gained via a Minimally Invasive Punching Technique
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Increased Diagnostic Certainty of Periprosthetic Joint Infections by Combining Microbiological Results with Histopathological Samples Gained via a Minimally Invasive Punching Technique

机译：通过将微生物学结果与通过微创冲孔技术获得的组织病理学样本组合微生物学结果增加了危险性关节感染的诊断确定

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Background: The diagnosis of low-grade infections of endoprostheses is challenging. There are still no unified guidelines for standardised diagnostic approaches, recommendations are categorised into major and minor criteria. Additional histopathological samples might sustain the diagnosis. However, ambulatory preoperative biopsy collection is not widespread. Method: 102 patients with hip or knee endoprosthesis and suspected periprosthetic joint infection (PJI) were examined by arthrocentesis with microbiological sample and histopathological punch biopsy. The data were retrospectively analysed for diagnosis concordance. Results: Preoperative microbiology compared to intraoperative results was positive in 51.9% (sensitivity 51.9%, specificity 97.3%). In comparison of preoperative biopsy to intraoperative diagnostic results 51.9% cases were positive (sensitivity 51.9%, specificity 100.0%). The combination of preoperative biopsy and microbiology in comparison to intraoperative results was positive in 70.4% of the cases (sensitivity 70.4%, specificity 97.3%). Conclusion: The diagnosis of PJI is complex. One single method to reliably detect an infection is currently not available. With the present method histopathological samples might be obtained quickly, easily and safely for the preoperative detection of PJI. A combination of microbiological and histopathological sampling increases the sensitivity up to 18.5% to detect periprosthetic infection.
机译：背景：诊断因子保护剂的低级感染是挑战性的。标准化诊断方法仍然没有统一的准则，建议分为重大和较小标准。其他组织病理学样本可能会持续诊断。然而，动态术前活检系列并不普遍。方法：通过微生物样品和组织病理学冲击活组织检查，通过关节穿刺检测102例髋关节或膝关节内或疑似髋臼瘤细胞感染（PJI）。回顾性分析数据以进行诊断一致性。结果：术前微生物学与术中结果相比，阳性为51.9％（灵敏度51.9％，特异性为97.3％）。相比，术前活组织检查对术中诊断结果51.9％阳性（敏感性51.9％，特异性100.0％）。与术中结果相比，术前活检和微生物学的组合在70.4％的情况下为阳性（敏感性70.4％，特异性97.3％）。结论：PJI的诊断复杂。目前无法可靠地检测感染的单一方法。利用本方法，可以快速，安全地迅速，安全地获得组织病理学样本，以便术前检测PJI。微生物和组织病理学采样的组合增加了高达18.5％的敏感性，以检测围堰感染。

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